New Study Could Change How Schizophrenia Is Treated

A new landmark study is changing the thinking on how to best treat schizophrenia. More than 2 million people in the U.S. have a diagnosis of schizophrenia, and they are typically treated with antipsychotic drugs that have strong side effects. The symptoms usually start between ages 16 and 30, according to the National Institute of Mental Health.

Now, a study published in the American Journal of Psychiatry and funded by the National Institute of Mental Health finds that schizophrenia patients who received smaller doses of antipsychotic medication and more focus on one-on-one talk therapy did better in their recoveries in the first two years of treatment, than those whose treatment was more centered around the antipsychotic drugs.

Dr. Robert K. Heinssen, director of the Division of Services and Intervention Research at the National Institute of Mental Health, oversaw the research and speaks with Here & Now‘s Robin Young about the findings of this study.

Interview Highlights: Dr. Robert K. Heinssen

On the early stages of schizophrenia

“Usually in the beginning, these are very private experiences that are very distressing to the individual and it's very common for those individuals to begin to withdraw from people around them. When they withdraw, the irrational thoughts or the aberrant experiences that they're having don't get corrected by feedback from outside themselves.”

Prescribed antipsychotic drugs can have serious side effects that deter some from taking the medication

“That's exactly right, and it's why it's a critical part of this care. That the provider – the medication provider, whether it's a psychiatrist or a nurse practitioner – is carefully tracking the experience of the individual, both in terms of their recovery, but also in terms of side effects that can be very distressing to the individual.”

On talk therapy

“So we're talking about a type of psychotherapy that really focuses in on the resilience of the individual who's receiving the services. There's a tailoring then of treatment to kind of wrap around the individual's particular needs. So in addition to this type of resilience-based psychotherapy, we also offer family education and support, because family members are key to assuring the long-term recovery of the individual. And then equally important is focusing on the person's academic, social and vocational goals. So an intervention that's called ‘Supported Employment, Supported Education' is something that plays a key role in this treatment because it takes into account the fact that most of these young individuals want to return to school, they want to become productive members of the workforce and it offers a very active intervention to get them at the places that they most desire and then offer support to them in those environments until they get their feet on the ground and are feeling confident and then it begins to recede into the background.”

Do you think the U.S. will be able to afford intervention programs?

“We're doing a cost-effective analysis now of the results of this clinical trial, but what we're expecting is that there will be some slight increase in cost in out-patient treatment. But when you account for the fact that there are fewer crisis episodes for people who are treated in this proactive way, the marginal increase in upfront costs will be offset by downstream savings.”

Guest

• Robert K. Heinssen, M.D., director of the Division of Services and Intervention Research at the National Institute of Mental Health (NIMH).

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