RESUMO
There is an increasing expectation that general practitioners will be more involved in treating people with schizophrenia. Newer drugs are associated with better clinical outcomes, especially in relation to negative symptoms (ie, apathy, under activity, slowness, social withdrawal). Some patients make a full recovery or are quite functional between episodes. Identifying early warning signs will lead to reduction of disability. Side effects of medication must be treated vigorously and expediently to enhance compliance. Secondary symptoms of dysphoria and depression must be treated to prevent suicide. Issues of alcoholism and substance abuse must be addressed, providing education on their implications for the course of the illness. People with schizophrenia need continuity of care, which the general practitioner may be best placed to provide because of a long-term commitment to the patient. Involvement with the family (education, support and a collaborative approach in monitoring and supporting the patient's well-being) is vital.
Assuntos
Serviços de Saúde Comunitária , Esquizofrenia/terapia , Adolescente , Adulto , Antipsicóticos/uso terapêutico , Família/psicologia , Humanos , Masculino , Cooperação do Paciente , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Transtornos Relacionados ao Uso de SubstânciasRESUMO
The authors found that the different hallucinated "voices" of four schizophrenic subjects reported over 1-3 weeks expressed semantic content that was at least as persistent as clauses sampled from single 5-7-minute conversational discourses of four comparison speakers. The high degree of semantic recurrence of voices from one day to the next may contribute to the mistaken belief that these experiences derive from a particular nonself agent or speaker.
Assuntos
Alucinações/psicologia , Psicologia do Esquizofrênico , Semântica , Fala , Adulto , Feminino , Alucinações/diagnóstico , Humanos , Distribuição Aleatória , Recidiva , Esquizofrenia/diagnósticoRESUMO
Twelve patients who met DSM-III-R criteria for schizophrenia and had persistent auditory hallucinations completed a diary three times daily for 2 to 3 weeks. Using 5-point equal interval rating scales, nearly all patients were able to record consistently the nature of their hallucinations, the intensity of their delusional beliefs, and the mood and clarity of their thinking. For at least half the patients, there was a statistically significant relationship between the loudness and intrusiveness of hallucinations and the intensity of delusional beliefs; the more intrusive and distressing were the hallucinations, the more anxious and depressed were the patients. The findings suggested that more emphasis might be placed on altering patients' mood in the treatment of persistent hallucinations. The diary approach to research into auditory hallucinations appears promising.