Family Interventions in the Community Management of Schizophrenia: Methods and Results

Abstract

The treatment of schizophrenia has changed to a great extent over the last 30 years. Owing to the widespread use of neuroleptic medication, the mean length of stay in hospital has shortened considerably, and many patients are now treated in the community. Without question, neuroleptic drug treatment is effective in promoting symptom reduction in acute exacerbations, and it also has a definite prophylactic effect in preventing subsequent exacerbations. The mean relapse rate after 1 year of continuous neuroleptic treatment is 41%, while under placebo conditions 68% of the patients relapse (Hogarty, 1984). However, despite the significant differences between placebo and verum the relapse rates are still high. Furthermore, long-term neuroleptic treatment is frequently accompanied by bothersome and often persistent side effects. These unpleasant effects include a variety of movement disorders, such as slowed, stiff motor behavior, involving facial and gestural expressions, tremor resembling Parkinson’s disease, restlessness, apathy, or drowsiness, and may persist irreversibly as in the case of tardive dyskinesia (Falloon, McGill, & Boyd, 1984).