26 - Psychosocial and pharmacological treatments for schizophrenia

Summary

Editor's note

One of the most striking advances in psychiatry in the last 50 years has been the improvement in the outcome of those with schizophrenia. Although it is commonly assumed that the largest part of this has been due to the introduction of effective drug treatments (starting with chlorpromazine), there have been major advances in both society's attitudes to schizophrenia and its psychosocial management that have played a major, if not the most important, part in this shift in outcome and general attitudes. The advances achieved are often difficult to evaluate as many are very complex interventions, but they have been considerable. It is perhaps worth noting that both our distinguished authors are very modest in their descriptions of these, but do not be misled; many are considerable advances that have helped to humanise the problems of those who were in the past regarded as degenerate and irredeemable.

Introduction

Once seen as a separate approach to the treatment of schizophrenia, the interventions under the psycho-social umbrella are now viewed as an essential aspect of modern management. They are partners with pharmacotherapy and form part of a multidisciplinary approach outlined in the previous chapter. Psycho-social interventions are often seen as part of a complex set of interventions, delivered by the range of services outlined in Chapter 8. However, the interventions described in this chapter are, in essence, simple and can be taught to, and delivered by, many individuals in a clinical team, perhaps with supervision from an expert.