Schizophrenia is a devastating brain disorder, and current treatments may not do enough to address the personal suffering, family burden, and cost to society linked to the illness.
But a landmark new study finds that a treatment combining talk therapy and low-dose medication is more effective than traditional medication-only treatment.
People who suffer from schizophrenia, a disorder that affects more than 2 million Americans may hear voices or have paranoid delusions that others are trying to control or harm them.
The study compared about 180 people with schizophrenia who got conventional, medication-only care with more than 220 people who received the combined treatment of low doses of medication and talk therapy. The people in the combined treatment stayed in treatment longer (a good thing, since the illness can’t be cured), had a more improved quality of life (defined by having more normal emotional and social interactions), fewer signs of illness, and were more involved in work and school.
Traditional schizophrenia treatment often involves high doses of anti-psychotic medications, which can be effective but often come with unpleasant side effects like weight gain, grogginess, and emotional numbing. As a result, as many as a quarter or more of people with schizophrenia stop taking medication within the first year.
A number of small studies have found promising results treating the disorder soon after the onset of psychotic symptoms, and combining medication with psychotherapy, assistance to patients’ families, and help staying in school or a job. This approach has been used in countries with nationalized healthcare, like Scandinavia, but it had never been studied on a broad scale in the US until now.
Towards a better treatment
The new study, conducted between July 2010 and 2012, involved 404 people aged 15 to 40 who’d been diagnosed with schizophrenia or a related psychosis-like schizoaffective disorder who had undergone less than six months of treatment with antipsychotic medication.
The researchers randomly assigned 34 clinics in 21 states to provide their patients with typical community care (whatever their doctor would normally prescribe), or combined therapy as part of a program called NAVIGATE, which included personalised medication, family education, individual psychotherapy, and job and education support.
Patients were evaluated on measures such as sense of purpose, motivation, emotional and social interactions, role functioning, and engagement in regular activities.
Those in the NAVIGATE program scored significantly better on these measures than those who received regular treatment. And patients who received the combination treatment within the first year and a half of getting their diagnosis had even more improved quality of life and recovery than those who got the treatment later or just had regular treatment.
The findings point to a potentially better way of treating schizophrenia, which could be good news for the millions of Americans who suffer from the disorder.
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