Among Patients with Schizophrenia: A Learning Curve for Psychiatrists

Abstract

Schizophrenia is a complex disorder and there are many intricate facets to its management. And the present chapter discusses how. While schizophrenia remains a complex disorder, it may serve as a learning curve for personal therapeutic and professional growth of a psychiatrist. The nature of the disorder, variances in its presentations, the varied symptom profiles and course, as well as prognosis all serve to complicate its management and outcome. The conundrum of poor insight coupled with the presence of negative symptoms that may be non-amenable to routine treatments makes recovery difficult. The role of medications while defined puts on the treating doctor the task of finding the right combination that would work for a patient while having minimal side effects and maximal improvement. Psychotherapy for schizophrenia has not yet been defined well, and there is a need for this approach combined with medical management. Difficulty in the psychotherapeutic management of schizophrenia is discussed. It is also very difficult for psychiatrists to keep abreast of the latest developments in neurobiology and genetics and translating the same into clinical practice. Research is moving at a fast pace and one cannot keep up to date with a busy clinical practice. The effect of treatment settings, religion, and myths is also laid out, with a final touch on the vagaries of the doctor-patient relationship in schizophrenia. Thus, schizophrenia as a disorder is a learning curve for most psychiatrists, and this curve moves as one grows in experience.