SCHIZOPHRENIA

Intense Early Intervention for Schizophrenia

By Sherry Baker and Temma Ehrenfeld @SherryNewsViews
 | 
January 30, 2024
Doctor diagnosing man with schizophrenia

Immediate, team-based treatment for psychotic episodes dramatically improves the future for people with schizophrenia. Here's what you should know.

Imagine hearing voices that no one else hears or thinking someone is reading your thoughts and planning to harm you.

Suffers of the symptoms of schizophrenia, a chronic brain disorder, can become frightened, agitated, or withdrawn during psychotic episodes. Some say nonsensical things when they try to convey what they are experiencing.

The symptoms interfere with attending classes, holding down a job, and maintaining relationships, often making a patient’s life spiral out of control.

 

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Fewer than 1 percent of Americans suffer from schizophrenia, which usually emerges during the late teens and early 20s in men, and the late 20s to early 30s in women.

Although medical treatment can help control symptoms, high doses of antipsychotic drugs may cause side effects — so many schizophrenics don’t take their medications. About 5 percent of people with schizophrenia commit suicide, the greatest risk occurring during the early stage. About half also have other mental disorders or addictions.

Evidence shows that intensive and early treatment after the first episode can make a huge difference.

In a study with 34 clinics nationwide, researchers followed more than 400 patients for about two years, concluding that the people who received intensive treatment fared significantly better. More than 360 publicly funded treatment programs using the system, called NAVIGATE, now operate in all 50 states, serving 10s of thousands of adolescents and young adults each year.

"The goal is to link someone experiencing their first episode of psychosis with a coordinated specialty care team as soon as possible after psychotic symptoms begin," said John M. Kane, MD, who headed the study for the Recovery After an Initial Schizophrenia Episode Early Treatment Program, funded by the National Institute of Mental Health (NIMH.) "Our study shows that this kind of treatment can be implemented in clinics around the country.”

The NAVIGATE model includes:

  • Psychotherapy aimed at recovery
  • Low doses of antipsychotic medications
  • Support with work or education (based on the individual's needs and preferences)
  • Case management
  • Family education and support

Specific decisions about treatment plans occur with input between the team of specialists and each patient. When possible, family members are also involved. 

A similar study is underway in Ontario, Canada, where care is being delivered virtually. Australia has also been a leader in early care for young people with schizophrenia.

The rapid spread of the model is unusual, according to NIMH experts. It is also notable because of the coordinated collection of data that can help all the clinics improve.

Signs of schizophrenia

In teenagers, the first signs (although they aren’t unusual at that age) may be:

  • A change of friends
  • A drop in grades
  • Sleep problems
  • Irritability

Especially if your family has a history of psychosis, be alert for signs that your child is becoming more isolated.

Symptoms of schizophrenia

Hallucinations

Hearing voices, seeing things, or smelling things others can’t perceive are hallucinations, which can appear to be real to the person with schizophrenia. The voices tend to be hostile or threatening.

Delusions

New ideas or facts won’t alter a delusion, a false belief that often doesn’t seem possible to observers. A person with delusions may have trouble with concentration and be easily confused.

Emotional flatness

Your child may seem depressed, talking in a dull, disconnected way, and show little interest in school, friends, or hobbies.

Not realizing you are sick

The technical term is anosognosia, meaning that the person doesn’t accept that he has an illness.

Causes of schizophrenia

The causes lie in both genetics and the world at large. Your chance of developing schizophrenia is more than six times higher if you have a close relative, such as a parent or sibling, with the disorder.

Autoimmune disorders, and exposure in the womb to viruses or malnutrition during the first and second trimester, increase the risk.

Heavy pot use among young teens may be a trigger for the first psychotic episode and make symptoms worse. Studies have also found that teens vulnerable to psychosis may be drawn to marijuana at a younger age.

Schizophrenia diagnosis

To make the diagnosis, a psychiatrist will evaluate your symptoms to rule out other causes of psychosis, which include using methamphetamines or LSD, bipolar disorder, or a brain tumor.

There is no lab test for this disorder.

 

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Updated:  

January 30, 2024

Reviewed By:  

Christopher Nystuen, MD, MBA and Janet O'Dell, RN