The popular opinion about schizophrenia has accustomed us to the stereotypical image of a patient with delusions and hallucinations, very often unpredictable, agitated. However, it turns out that schizophrenia can have two faces. The latter are patients who completely withdraw from public life and become indifferent to the outside world — they can stay in their apartment for months, mostly sleeping, listening to the radio and smoking cigarettes. According to the report “Schizophrenia with negative symptoms. The burden of illness is on the sick and their relatives”, 70% of them are on disability pensions due to incapacity for work, and almost half of them have stopped their studies.
Schizophrenia is one of the most stigmatizing and severe chronic mental health conditions. People with schizophrenia make up a huge, second-largest group of psychiatric hospitals just after patients treated for alcohol misuse disorders. Epidemiological data show that at least 250 people live with schizophrenia in Russia, of which about 000 receive various medical services every year. However, due to undiagnosed people not seeking medical help, the number of people with schizophrenia can reach even 180 people.
How to improve the quality of life of patients?
To improve the quality of life of this group of patients, it is important to be aware of the negative symptoms, correctly diagnose and treat them. However, the main thing is to initiate volitional processes so that the patient can benefit from various forms of therapy. Currently available antipsychotics are effective mainly in the area of positive symptoms and to a much lesser extent in reducing negative symptoms and cognitive dysfunction. Therefore, currently, patients with predominantly negative symptoms receive a suboptimal treatment plan. This remains a huge problem and an unmet health need.
General knowledge about schizophrenia with negative symptoms should be the starting point for a holistic approach to patients, including: community-based care in line with the National Mental Health Program and the Mental Health Centers created through it, education of patients and their caregivers patients, and assistance in returning patients to social roles, incl. through study and work. However, due to the patient’s state of health and the characteristics of the negative symptoms, the implementation of such forms of activation requires a lot of mobilization, and most often their implementation and continuation depend on the determination of their relatives. Despite the fact that patients are reluctant to use the available forms of care, adherence to recommendations and activation of patients is as in the context of pharmacological therapy.