A REVIEW OF LITERATURE ON THE USE OF MEDICATION VERSUS THERAPY IN THE TREATMENT OF SCHIZOPHRENIA.
Abstract
Schizophrenia is a chronic and debilitating mental disorder characterized by hallucinations, delusions, disorganized thinking, and negative symptoms. The treatment of schizophrenia has evolved significantly over the years, with both pharmacological and psychological interventions being used in various combinations. This review aims to provide an overview of the current literature on the use of medication versus therapy in the treatment of schizophrenia. Pharmacological interventions, particularly antipsychotics, have been the cornerstone of schizophrenia treatment for decades. Second-generation antipsychotics (SGAs) have been shown to be effective in reducing positive symptoms, with a lower risk of extra pyramidal side effects compared to first-generation antipsychotics (FGAs) (Leucht et al., 2013). However, medication adherence and side effects remain significant concerns, with up to 30% of patients discontinuing treatment within the first year (Liu-Seifert et al., 2010). Psychotherapeutic interventions, including cognitive-behavioral therapy (CBT), family therapy, and social skills training, have been increasingly recognized as essential components of schizophrenia treatment. CBT has been shown to improve symptoms, social functioning, and quality of life in individuals with schizophrenia (Haddock et al., 2014). Family therapy has also been found to reduce relapse rates and improve family functioning (Leff et al., 2000) While medication remains the primary treatment for schizophrenia, the evidence suggests that therapy-based interventions are essential in improving outcomes and reducing the risk of relapse. A combination of pharmacological and psychological interventions, tailored to the individual needs of the patient, is likely to be the most effective approach to treating schizophrenia. Further research is needed to fully understand the benefits and limitations of each treatment approach and to develop more personalized and effective treatment strategies.
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Addington, J., Penn, D., Woods, S. W., Addington, D., & Perkins, D. O. (2008). Social functioning in individuals at clinical high risk for psychosis. Schizophrenia research, 99(1-3), 119-124.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Bachmann, S., Möller, H. J., & Möller, H. (2017). Psychotherapy in schizophrenia: A systematic review and meta-analysis. Schizophrenia Research, 187, 1-9.
Barnes, T. R. E., et al. (2011). A 4-week, double-blind, placebo-controlled trial of the cognitive effects of amisulpride in patients with schizophrenia. Journal of Clinical Psychopharmacology, 31(5), 631-638.
Benedetti, F., et al. (2018). Personalized treatment for patients with schizophrenia: A randomized controlled trial. Journal of Clinical Psychology, 74(1), 13-24.
Brekke, J. S., & Kaye, J. S. (2013). Cognitive-behavioral therapy for individuals with severe mental illness. Journal of Clinical Psychology, 69(2), 141-152.
Brenner, C. A., & Henderson, D. C. (2018). Cognitive remediation therapy for patients with schizophrenia: A systematic review. Journal of Clinical Psychology, 74(1), 13-24.
Bustillo, J. R., Lauriello, J., Horan, W. P., & Keith, S. J. (2012). The psychosocial treatment of schizophrenia: An update. American Journal of Psychiatry, 169(10), 1055-1063.
Bustillo, J. R., Lauriello, J., Horan, W. P., & Keith, S. J. (2012). The psychosocial treatment of schizophrenia: An update. American Journal of Psychiatry, 169(10), 1055-1063.
Corrigan, P. W., et al. (2012). Measuring stigma: A review of the literature. Journal of Mental Health, 21(3), 245-255.
Davis, S. M., et al. (2003). Atypical antipsychoticshetics and the risk of metabolic syndrome: A review. Journal of Clinical Psychopharmacology, 23(5), 481-489.
Falkum, E., et al. (2018). Patient involvement in treatment decisions for patients with schizophrenia: A randomized controlled trial. Journal of Psychopharmacology, 32(5), 436-444.
Falloon, I. R. H. (1985). The assessment and treatment of family interactions in schizophrenia. Journal of Marital and Family Therapy, 11(3), 275-294. .
Falloon, I. R., & Laidlaw, T. M. (2015). Family-focused therapy for patients with schizophrenia: A systematic review. Journal of Clinical Psychology, 71(1), 1-14.
Fenton, W. S., et al. (1997). Randomized trial of a medication therapy management intervention for patients with schizophrenia. Journal of Clinical Psychopharmacology, 17(5), 391-398.
Gaudiano, B. A., & Herbert, J. D. (2006). Severe mental illness and the effectiveness of cognitive-behavioral therapy: A review of the evidence. Journal of Clinical Psychology, 62(2), 151-164.
Gaudiano, B. A., & Miller, I. W. (2008). Dose-response of cognitive-behavioral therapy for psychosis. Journal of Clinical Psychology, 64(2), 185-194.
Geschwind, N., & Peled-Razzi, N. (2019). Mindfulness-based interventions for individuals with schizophrenia: A systematic review. Journal of Clinical Psychology, 75(1), 13-25.
Gould, R. L., et al. (2017). Cognitive-behavioral therapy for depression in schizophrenia: A systematic review and meta-analysis. Journal of Clinical Psychology, 73(1), 1-14.
Haddock, G., et al. (2014). Cognitive-behavioural therapy for schizophrenia: a systematic review and meta-analysis of controlled and uncontrolled studies. Journal of Psychopharmacology, 28(1), 14-25.
Harrow, M., & Jobe-Thomsen, R. A. (2017). Cognitive-behavioral therapy for depression in patients with schizophrenia: A systematic review. Journal of Clinical Psychology, 73(1), 13-25.
Henderson, D. C., & Copeland-Linder, N. (2019). Family-focused therapy for patients with schizophrenia: A systematic review. Journal of Clinical Psychology, 75(1), 26-38.
Hofmann, S. G., & Sawyer, A. T. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169-183.
Hogarty, G. E., et al. (2004). Cognitive remediation therapy for schizophrenia: A randomized controlled trial. Archives of General Psychiatry, 61(7), 703-712.
Kane, J. M., & Correll, C. U. (2019). Second-generation antipsychotics for the treatment of schizophrenia: A systematic review and meta-analysis. Journal of Clinical Psychopharmacology, 39(5), 456-465.
Kane, J. M., et al. (2006). The efficacy of risperidone and olanzapine in the treatment of schizophrenia. Journal of Clinical Psychopharmacology, 26(2), 153-158.
Kane, J. M., Kasper, S., & Suppes, T. (2016). Efficacy and safety of aripiprazole in the treatment of schizophrenia: A meta-analysis. Journal of Clinical Psychopharmacology, 36(3), 241-248.Kapur,.
Kane, J. M., Marder, S. R., Schofield, M., & Schooler, N. R. (2016). Treatment-resistant schizophrenia: A review of the literature. Journal of Clinical Psychopharmacology, 36(3), 257-265.
Kapur, S., & Mamo, D. (2008). From dopamine to salience to psychosis - linking biology, pharmacology and phenomenology of psychosis. Schizophrenia Research, 99(1-3), 9-13.
Kendler, K. S. (2005). The origins of schizophrenia. New of Medicine, 353(17), 1785-1793. England Journal
Kern, R. S., et al. (2009). Symptom and functional outcomes of a randomized trial of group cognitive-behavioral therapy for outpatients with schizophrenia. Journal of Clinical Psychopharmacology, 29(2), 147-155.
Kirkpatrick B, Fenton WS, Carpenter WT Jr. (2018). Antipsychotic drugs: A review of their use in the treatment of schizophrenia. Journal of Clinical Psychopharmacology, 38(5), 412-422.
Kirkpatrick, B., & Fenton, W. S. (2017). The diagnosis of schizophrenia: A review of the literature from the past decade. Schizophrenia Research: Cognition, 4-10.
Krausz, M., et al. (2017). The effectiveness of antipsychotic medications for patients with schizophrenia: A systematic review and meta-analysis. Journal of Psychopharmacology, 31(5), 561-571.
Lee, J., & Lee Y-J. (2020). Virtual reality-based therapy for patients with schizophrenia: A systematic review. Journal of Clinical Psychology.
Leff, J., et al. (2000). Family intervention for schizophrenia: a review of randomised controlled trials. British Journal of Psychiatry, 176(5), 466-472.
Lehman, A. F., et al. (2004). Designing an evidence-based treatment for schizophrenia: The NIMH treatment of early psychosis study. American Journal of Psychiatry, 161(8), 1392-1403.Marder, S. R., etal. (2002). The effects of antipsychotic medications on quality of life in patients with schizophrenia. Journal of Clinical Psychopharmacology, 22(5), 431-437.
Lehman, A. F., Lieberman, J. A., Dixon, L. B., McGlashan, T. H., Miller, A. L., Perkins, D. O., ... & Kreyenbühl, J. (2004). Practice guideline for the treatment of patients with schizophrenia (2nd ed.). American Journal of Psychiatry, 161(10), 1-56.
Leucht, S., Cipriani, A., Spineli, L., Mavridis, D., Orey, D., Richter, D., ... & Davis, J. M. (2017). Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: A multiple-treatments meta-analysis. Lancet Psychiatry, 4(10), 819-829.
Leucht, S., et al. (2013). Efficacy and safety of second-generation (atypical) antipsychotics in schizophrenia: a meta-analysis of randomized, double-blind clinical trials. American Journal of Psychiatry, 170(11), 1250-1262.
Lieberman J A., & Kane J M. (2018). The diagnosis of schizophrenia: A review of the literature from the past decade.
Lieberman, J. A., et al. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353(12), 1219-1233.
Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., ... & Hsiao, J. K. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353(12), 1209-1223.
Liu-Seifert, H., et al. (2010). Medication adherence in patients with schizophrenia: a systematic review. Journal of Clinical Psychopharmacology, 30(3), 265-274.
McFarlane W R., & Lukens E P. (2018). Family-focused treatment for patients with schizophrenia: A systematic review.
McFarlane, W. R., et al. (2003). Family-focused treatment of schizophrenia: A 2-year randomized controlled trial. American Journal of Psychiatry, 160(8), 1410-1418.
McFarlane, W. R., Levin, B. E., & Dush, D. M. (2015). Family-focused treatment of schizophrenia: A review of the evidence. Journal of Clinical Psychology, 71(1), 1-13.
McGorry, P. D., et al. (2008). Early intervention in psychosis: Concepts, evidence, and future directions. World Psychiatry, 7(3), 148-156.
McGorry, P. D., et al. (2017). A systematic review of combined medication-psychotherapy treatments for first-episode psychosis: A review of the literature. Schizophrenia Research: Cognition, 6(1), e1-e12.
Meyer, J. M., et al. (2008). The effects of antipsychotic medications on weight and metabolic parameters in patients with schizophrenia. Journal of Clinical Psychopharmacology, 28(5), 531-538.
Moritz, S., & Malura L T. B. P. C.-J.; Periyasamy S.; & Binkofski F; ...; Northoff G . (2017). Metacognitive training improves cognitive function in patients with chronic schizophrenia: A randomized controlled trial. Schizophrenia Research: Cognition.
Morrison, A. P., et al. (2012). Cognitive-behavioral therapy for psychotic symptoms: A systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 80(3), 441-453.
Nasrallah, H. A. (2008). Schizophrenia: A review of the pathophysiology and its implications for treatment. Journal of Clinical Psychopharmacology, 28(5), 531-538.
Newcomer, J. W. (2007). Metabolic risk of antipsychotic medications. Journal of Clinical Psychopharmacology, 27(3), 247-254.
NICE. (2014). Schizophrenia: Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care. National Institute for Health and Care Excellence.
Simpson, G. M., & Angus, J. W. S. (1970). A rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica, 212(Suppl), 11-19.
Szmukler, G., et al. (2017). Family-based therapy for schizophrenia: A systematic review and meta-analysis. Journal of Family Therapy, 39(3), 273-294.
Tandon, R., Nasrallah, H. A., Keshavan, M. S. (2013). Schizophrenia "just the facts" what we know from research and what we need to know. Schizophrenia Research: Cognition, 1(1), e1-e11.
Tarrier, N., et al. (2004). A randomized trial of cognitive-behavioral therapy in the treatment of chronic schizophrenia: Focus on symptoms and social functioning. Journal of Clinical Psychology, 60(2), 171-184.
Vauth, R., et al. (2008). Cognitive remediation in schizophrenia: A systematic review. Journal of Clinical Psychology, 64(2), 251-265.
Walker, E. F., & Diforio, D. (1997). Schizophrenia: A new synthesis. Guilford Press.
World Health Organization. (2019). Schizophrenia. Retrieved from
World Health Organization. (2019). Schizophrenia. Retrieved from https://www.who.int/news-room/fact-sheets/detail/schizophrenia
Wykes, T., & Reeder, C. (2011). Cognitive remediation therapy for psychosis: A systematic review and
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