Treatment and the Quality of Life by Roderick Shaner, MD

 We've made steady progress in our  ability to decrease psychotic symptoms of  psychiatric disorders. But is the successful  treatment of symptoms of schizophrenia  always related to an improvement in the  quality of life of those who suffer from it? Treating symptoms of an illness may not  improve the quality of life, if other results of  the treatment are bad. If confinement in a  locked facility reduces the danger of harm to  a patient, but results in a monotonous and  unstimulating existence, can quality of life be  said to have improved? Or if an antipsychotic  medication stops hallucinations but causes  severe sedation or muscle stiffness, is this a  better experience?

 Taking into account the quality of Life. Until recently, research measurements of  the efficacy of medical treatments have not  taken into account quality of life. This may  be because measurement of specific target  symptoms for various treatments is relatively  straight forward and reliable, but  measurements of life quality are more  difficult.
To measure life's quality, we must agree  upon what it is and how to measure  it. This takes effort and money, but such  work is now being done. Their is a growing recognition that  quality of life is a critical aspect in assessing  the usefulness of treatments for  schizophrenia, and several measurement  techniques have been devised. Some writers  have recently suggested that an assessment of  quality of life should be a requirement for  approval of all new antipsychotic drugs. Measuring the quality of life Investigators attempting to measure the  effect of treatment on quality of life have  cited several important components. One  obvious component is improvement of target  symptoms, which might include  hallucinations, delusions, illogical thinking,  and anxiety. Another component is the side  effects of treatment, both physical and  mental. Psychosocial performance, which  includes vocational ability and interpersonal  abilities, is also taken into account. Most rarely cited is how the patient  himself feels about the treatment. This  subjective measure has often been lacking  because of a belief that patient reports are  difficult to obtain or unreliable. Recent  evidence, however, suggests that self-reports  by patients with schizophrenia are in fact  highly reliable, and correlate closely with  outcome of treatment. Directions for the future during the upcoming "decade of the  brain," we can expect major progress in the  understanding of neuro-biochemistry, and in  our ability to improve symptoms of  schizophrenia. But we must also bear in  mind that the suffering that schizophrenia  causes is complex. Treatment that fails to  take into account the resultant quality of life  of patients is treatment that runs a risk of  becoming a problem of its own. The recent  inclusion in the scientific literature of quality  of life measurements is very encouraging.

 The quality of life at the Anne Sippi Clinic At the Anne Sippi Clinic, a global  treatment philosophy continues to emphasize  quality of life for our patients. The clinic strives to maintain a stimulating  environment, unlocked and open to the  community. Patients are consistently  encouraged to interact not only with each other  but with the outside community as well. Field  trips and community service are an important  part of Clinic life. Antipsychotic medication is  carefully used to decrease the symptoms of  psychosis, while minimizing side effects.

 Since the inception of the Anne Sippi  Treatment model by Jack Rosberg, the subjective experience of the patient plays a central role in treatment, and in  outcome assessment. While many of our patients have long  histories of treatment failures and confinement  to locked facilitates in the past, they now have  a higher quality of life at the Anne Sippi  Clinic. If quality of life is a valid measure of  treatment success, then the Anne Sippi  philosophy is a step in the right direction.

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The schizophrenia help.com website provides patients, family members, and caregivers with information on important alternative psychotheraputic treatment for anyone suffering with schizophrenia, in particular the and other common treatment resistant who are successfully helped. We approach the treatment of schizophrenia with alot of care and love for these individuals suffering from this mental illness.



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