Psychiatrists today are more in agreement about what works in the treatment of schizophrenia than ever before. Like debating the causes of schizophrenia (nature vs. nurture), those debating treatment options generally agree that a mixture of both drugs and socialization is the best answer.
According to Warner (2000), medications are an important but only a partial part of treatment. They reduce the observable positive symptoms, such as abnormal experiences and perceptions such as delusions, hallucinations, illogical or disorganized thinking and inappropriate behavior, but hardly have any effect on the negative symptoms, such as anhedonia, social withdrawal, and loss of motivation. Since their introduction in the 1950s, the antipsychotics have improved a great deal, and can now provide benefits while causing less severe side effects. Recent antipsychotics such as these are Clozapine, Risperidone, and Olanzapine.Despite typical neuroleptics’ successful treatment of positive symptoms, and even getting them into remission, there has been noted a continuing cognitive deficit among schizophrenics treated with these antipsychotic medications. Sharma & Harvey (2000) have noted that the prefrontal cortex (PFC) is highly correlated with being the site where much of he cognition impairments suffered by schizophrenics are. According to Sharma & Harvey,
The PFC has rich catecholaminergic innervation so that dysfunction of this brain region probably could involve disruption of normal dopaminergic and norandrenergic functioning. Therefore, pharmacological remediation of cognitive symptoms through manipulations of these neurotransmitter systems merits investigation. (p. 303)This is, therefore, an emerging area of study as far as pharmacotherapy is concerned.
Walker (2000) continues on about other types of treatment that should be coupled with medication, noting such things as family involvement, social rehabilitation, non-punitive methods for reprimand and maintaining a job. As with many social activities, the acceptance and support of family and friends can help the patient recover better, more quickly, and may even help prevent relapse. Ultimately, the goal is for the patient to live in the real world, and so social rehabilitation becomes an integral part of psychosocial methods, strengthening the schizophrenic’s role in the community, learning basic living and job skills.
Bryson, Lysaker & Morris (2002) conducted a study that intended to test how effective paid work can be on the quality of life of a schizophrenic. Ninety subjects were randomly assigned to two groups: one working without pay, and one working with pay. Subjects were assessed using the Heinrichs Quality of Life Scale (QLS). What the researchers found was that, not only were improvements found in overall QLS, but also in the domain of intrapsychic foundations, such as motivation, sense of purpose, anhedonia and empathy. They took the study further by following it up with a study that tested degree of work participation. The results were similar to their other study, finding that those who actively worked more reported higher scores on the QLS. Paid subjects were also found to have worked more hours than non-paid ones, suggesting that securing a paying job could be a major source of fulfillment for a schizophrenic.