What are the steps following diagnosis?

Once someone’s been diagnosed with schizophrenia, the inevitable question is how do we treat it? What are the treatments? What’s the prognosis?

These are really important questions, which have a myriad of different answers, depending on the individual and the context of their illness.

I’ll try and distill it into a fairly brief description.

Firstly, schizophrenia is a lifelong condition in most circumstances. So once you have an established diagnosis of schizophrenia, the individual is likely to have that for many, many years. A bit like some other chronic medical conditions such as asthma, or diabetes, they are often lifelong conditions.

However, schizophrenia does tend to wax and wane a little bit depending on the circumstances. So stress in one’s life tends to worsen the symptoms of schizophrenia.

Treatment

The treatment can broadly be looked at in terms of medical and non-medical treatments.

The medical treatments are drugs or medicines called antipsychotic medicines which are moderately effective in the treatment of schizophrenia. There are at least a dozen of these. There are some older medicines and there are some newer medicines which have emerged in recent times that have much less side effects and in some instances are more effective.

So at the cornerstone of the treatment of schizophrenia is medicine. But the other element is psycho-education, psychosocial support.

So, for someone to benefit from their treatment they need to be able to reduce stress in their life. They need to be able to be educated in how they can self manage. They need psychological support, and if they are living at home the family is a very important part of this.

In terms of management of schizophrenia, one always need to look at, on the one hand, the medical or the medicine side, as well as on the non-medical, the psychological, the psychosocial support. And for someone to have the best treatment outcome it’s those blending of the two in an effective manner which produces the results that one would hope to see to get the best outcome.

Dr Matthew Cullen, Psychiatrist, St Vincent’s Hospital, Sydney

Last Reviewed: 01/06/2020

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