Bases Clínicas para un Nuevo Modelo de Atención a las Psicosis

Abstract

The purpose of this paper is to summarize our current knowledge about pharmacological, psychosocial, and other emerging treatments for psychoses. Although antipsychotic medications are the mainstay of treatment for psychoses, and particularly for schizophrenia, the degree of improvement in positive symptoms is moderate, and has no demonstrable efficacy against positive enduring or deficit negative symptoms. Indeed, many patients continue to suffer from persistent positive symptoms and relapses, particularly when they fail to adhere to prescribed medications. This underlines the need for additional treatment methods to help patients understand and manage their disorders, alleviate symptoms, improve adherence, social functioning and quality of life, and solve problems that do not fully respond to medication. Nowadays, comprehensive treatment entails a multi-modal approach, including medication, psychotherapy and social treatments (psychoeducation and coping-oriented interventions, cognitive behaviour therapy, cognitive remediation, social skills training and assertive community treatment), as well as assistance with housing and financial sustenance. In the foreseeable future, phase-specific interventions ought to be applied to different stages of psychosis.