Survey on treatment for schizophrenia sheds new light on what people with schizophrenia feel is important for long-term quality care

Oct 13 2004

Details from a large-scale survey focusing on treatment goals for schizophrenia shed new light on what physicians and people with schizophrenia feel is important for long-term quality care, according to Ronald J. Diamond, M.D., co-author of the study.

"When we treat people with any kind of chronic illness, especially schizophrenia, it's important that we listen to their life goals, what they want out of treatment and what they want out of life," said Dr. Diamond, a professor of psychiatry at the University of Wisconsin at Madison, medical director at the Mental Health Center of Dane County and consultant to the Wisconsin Bureau of Community Mental Health and Substance Abuse, Madison, Wisc. "This study examines the similarities and differences of what schizophrenia patients and their physicians view as primary treatment goals." Dr. Diamond spoke today at the American Medical Association's 23rd Annual Science Reporters Conference in Washington D.C.

In the schizophrenia treatment goals survey, physicians and people with stable schizophrenia both reported their top treatment goals were improving mental health and improving overall happiness.

"One of the more surprising results of the survey was how similar the goals of both psychiatrists and people with schizophrenia in outpatient settings were," Dr. Diamond said. "The idea of truly listening to patients and questioning their goals has really caught on. As we can see from the survey, the top goal of both physicians and people with schizophrenia parallel each other, which means as psychiatrists - we've got it."

However, some differences in treatment goals remain. People with schizophrenia were more interested and focused on decreasing psychotic symptoms such as hearing voices. In general, physicians were focused on treating symptoms. According to the survey, people with schizophrenia have shifted their focus to life goals rather than treatment goals. They ranked the following significantly higher than physicians: returning to favorite hobbies and activities, decreasing feelings of being isolated due to schizophrenia and improving physical health.

A real problem with schizophrenia is the social stigma, Dr. Diamond said. "We aren't afraid of someone who is dangerous such as a drunk driver because they could be our neighbor or a cousin. Yet when we see someone who is different and may act strange, we become afraid of them for no real reason," he said. "Decreasing the stigma we have of people with mental illness is a constant battle. It's still just the beginning of acknowledging mental illness and incorporating people with mental illness into society."

Among the patients in the study, males outnumbered females 60 to 40 percent and the overall average age was 46 years. Of those with schizophrenia, more than 80 percent were diagnosed more than five years ago. The majority (70 percent) of schizophrenia patients surveyed were receiving treatment at community mental health centers with 96 percent being treated on an outpatient basis. Physician participants in the study were 32 percent female. The physicians surveyed were highly experienced. The majority have been treating schizophrenia patients for more than 10 years and more than half (52 percent) see more than 200 patients per month.

"In order for a psychiatrist to successfully treat a person with schizophrenia, it is necessary to have a respectful listening session where the physician gets to know the person, learn who they are and what they want from life," Dr. Diamond said. "If I don't know this person with or without schizophrenia, I'm not going to know how to direct them. We are trying to help them achieve their life goals rather than impose something on them."