September 28, 2004

Talk Therapy Important to Treatment

Dr. Peter Weiden and colleagues at SUNY Downstate Medical Center (NY) are implementing an approach to schizophrenia treatment that British doctors are already using with success - a treatment plan that includes both medication and talk therapy as essential elements.

Medication is vital for stabilizing some symptoms of the disease; however, many people have trouble achieving a full recovery using medications alone. The current antipsychotics may only reduce symptoms in 60-80% of patients, and even among these, medication might not always control all symptoms adequately. For others, medications that have helped in the past may stop working.

Says Weiden: "The new medicines have been a breakthrough, but at the end of the day, the patients still have schizophrenia. We want to understand how abnormal thoughts guide behavior."

The idea of talk therapy is not only to reinforce positive behavior patterns, but also to allow the doctor to understand exactly how the illness is affecting the lives of his/her patients.

This strategy has already proven to be successful in Europe. Since 1990, British psychiatrists have used cognitive behavioral therapy to benefit people with schizophrenia. According to their research, it reduces hallucinations and delusions in people who haven't responded to medications.

According to one study, doctors reported that patients receiving 20 hours of cognitive behavioral therapy over 10 weeks had a 50% reduction in symptoms, and spent less time in the hospital.

Through cognitive behavioral therapy, which explores with the patient how the illness affects their lives and what specific coping strategies can help, doctors can focus on helping specific troubling issues. For example, insomnia is a common problem among people with schizophrenia, and the stress caused by lack of sleep may worsen psychotic symptoms. Sleep difficulties is a contained problem that can be focused on and addressed by cognitive behavioral therapy.

Doctors are optimistic that recovery from schizophrenia is achievable. Rather than a progressively degenerative disorder, current thinking classifies schizophrenia as symptoms that can appear and disappear, or diminish with effective treatment.

Stigma, and a lack of social integration programs focused on housing and work, are all barriers to schizophrenia recovery. Perhaps cognitive behavioral therapy can address some specific coping strategies that will help patients re-integrate themselves back into a community.

For the full story, see: "Putting stability in schizophrenia: Talk therapy reinstated as part of treatment" (Sept 28 2004). Available at (

See another recent story on cognitive rehabilitation for schizophrenia, available in the Newsblog (Sept 10, 2004 entry).


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