Conference Coverage

Managing schizophrenia as a chronic disease linked to better outcomes


 

REPORTING FROM THE COLLEGE 2018

– The secret to optimal long-term disease control in schizophrenia is to implement the same type of continuous and close management provided to other chronic diseases, like hypertension or inflammatory bowel disease, according to a lecture delivered at the annual meeting of the American College of Psychiatrists.

In the Dean Award Lecture – a talk characterized as “a stroll through the long-term understanding of the treatment of schizophrenia” – Ira D. Glick, MD, said that, although antipsychotics provide the foundation of disease control, patients and families need to understand and respect disease chronicity.

Dr. Ira D. Glick, professor emeritus of psychiatry and behavioral sciences at Stanford (Calif.) University

Dr. Ira D. Glick

Dr. Glick remembered speculation in his training that bad parenting might be a cause or contributor to the development of schizophrenia. Now, genetic susceptibility is recognized as a dominant factor for both developing the disease and determining severity, said Dr. Glick, professor emeritus in the department of psychiatry and behavioral sciences at Stanford (Calif.) University. Regardless of etiology, however, he believes that convincing patients and families that schizophrenia is a lifetime disease is a critical first step to treatment compliance that optimizes adequate symptom control.

“In the last 5 or 6 years, I did something that no one has ever done before. I looked at the outcomes of patients treated for decades,” Dr. Glick recounted. Specifically, he contacted patients who had been in his care for up to 50 years. In “this naturalistic study,” he specifically asked the patients to rate their adherence to antipsychotics and to provide a global assessment of their life satisfaction, both on a scale of 1-10.

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