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Expert panel calls for raising the bar in treating schizophrenia


National survey shows patients want treatments to control broader range of symptoms giving them a second chance at life

A panel of experts says doctors treating patients with schizophrenia should be targeting symptoms beyond hallucinations and delusions, and focus in on the common, but often overlooked, symptoms of depression and anxiety, as well as the inability to think clearly. Patients agree, ranking these symptoms as major concerns in a recent national survey. As a result, the expert panel, convened by MBL Communications, Inc., publishers of the trade journals Primary Psychiatry and CNS Spectrums, will be issuing a consensus statement about new treatment goals for schizophrenia.

"For decades, psychiatry has focused almost solely on managing a patient’s ’positive symptoms,’ such as hallucinations and delusions, because for previous treatments, that is pretty much all we had to offer," said Philip D. Harvey, PhD, professor of psychiatry at Mount Sinai School of Medicine and chief psychologist at Mount Sinai Hospital. "Today, patients and physicians should expect that more of the disease symptoms can be controlled, and that people with schizophrenia can have a more meaningful life."

With the advent of atypical antipsychotics, it is now possible to effectively treat the positive symptoms of hallucinations and delusions, as well as affective symptoms such as depression and anxiety. Furthermore, cognitive impairment (such as the inability to think clearly and difficulty concentrating) and impaired social function can also be alleviated. By targeting the broader spectrum of symptoms, these medications allow patients to function better in daily life.

"It takes time for advances in care to actually be used by physicians to benefit patients," said David Ginsberg, MD, section editor, MBL Communications, Inc. and director, Outpatient Services, Tisch Hospital Department of Psychiatry at New York University Medical Center. "The recent major advances we have seen in the treatment of schizophrenia are so important that we feel physicians need to expand upon their expectations to encompass a broader view of the patient. The development of a consensus statement is one step in that direction."

According to the survey, revealed for the first time during the panel discussion, patients report that it is "very important" for them to have the symptoms of hallucinations and delusions controlled, as well as depression and the inability to think clearly, concentrate or remember. Almost all of those surveyed (94%) believe that improved daily functioning is part of successful treatment for their illness, including the ability to work, shop and participate in hobbies as they normally would.

"Research shows that affective and cognitive symptoms have a tremendous impact on the suffering and frustrations that patients struggle with in order to cope with this difficult illness. It is these symptoms that are the greatest barriers to achieving a meaningful social and professional recovery," said Peter J. Weiden, MD, professor of psychiatry and director of the Schizophrenia Research Service at State University of New York (SUNY) Downstate Medical Center in Brooklyn. "This survey shows that patients are often ahead of their doctors in knowing the importance of affective and cognitive symptoms."

The panelists also included: Peter Buckley, MD, professor and chairman of the Department of Psychiatry and Behavioral Health at the Medical College of Georgia and Nina R. Schooler, PhD, adjunct professor of psychiatry at Georgetown University School of Medicine. Their presentations and aspects of the patient survey results will be published as a supplement in the February issues of CNS Spectrums and Primary Psychiatry.

Elaine Metcalf | EurekAlert!
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