Problems of Therapy of Outpatients with Schizophrenia (reverse Side of Psychopharmacotherapy)

Abstract

Introduction application of the evidence-based medicine in psychiatry undoubtedly is a basis of successful treatment of schizophrenia and emergence of new psychopharmacological data strengthens it. However noncritical perception of progress in psychopharmacology makes understanding of strategic objectives of schizophrenia’s treatment very oversimplified. Objective to define a position of psychiatrists about role of psychopharmacotherapy in structure of schizophrenia’s treatment at outpatients. Materials 100 psychiatrists of an outpatient-clinic, medical documentation (of 570 outpatients with schizophrenia). Methods the standardized analysis of medical documentation; the structured interview which defined: a) the knowledge of psychiatrists about neuroleptics b) subjective criteria of neuroleptic choice c) the doctor’s purposes in treatment of the outpatient with schizophrenia. d) set of the therapeutic techniques applied by the doctor. Results 100% of doctors have basical knowledge about neuroleptics; 20% declared direct dependence of efficiency of shizophrenia’s treatment on “right choice” of preparation. In 80% of cases more critical relation to pharmacotherapy was defined, borders of its application were outlined, but only 15% confirmed these words in practice, using psychopharmacotherapy as ONE of instruments of treatment, equally with psychoeducation etc. Other's treatment consisted in “suitable” preparation or medicinal combinations searching; psychoeducation included only informing about medicine. Conclusion The tendency of substitution of the concept “treatment, as process of compensation (or restoration) the patient's premorbid status, by the concept “choice of the preparation with the proved efficiency” is traced in practice. Selection of the instrument of treatment turns into the treatment’s purpose that involves limitation of medical tactics and negative consequences for patients.