Reactions related to the symptoms


People close to the patient with schizophrenia are often uncertain on how best to react to the patient’s unusual or clearly erroneous statements.

Stock photo. Posed by model.

The bizarre beliefs and hallucinations are real enough for schizophrenia patients. These are not figments of their imagination. Instead of “going along” with the patient’s delusions, family members or friends can tell the patient that they don’t see it in the same way or that they disagree with the patient’s statements, though they should acknowledge the legitimacy of the disagreement.

Caregivers have to be careful not to contradict the patient’s beliefs; however, they should not go along or agree with the patient’s delusions. This can undermine the patient’s self-esteem and his or her coping strategy, which can lead to relapse.

It might be useful if the acquaintances of the patient with schizophrenia keep a record of the symptoms, medications taken (and doses administered) and the effects of the different treatments with the consent of the patient. Observing earlier symptoms can help family members in recognizing the signs of a relapse.

Family members may be able to spot early warning signs of a possible relapse such as increased withdrawal or changes in the sleeping pattern. Thus, recurrent psychosis can be detected in early stages and the entire relapse can be prevented with the proper treatment.

If family members know which medications have worked earlier and which ones had adverse effects, they can greatly help the treating physician in rapidly finding the best possible treatment.

  • References

    1. APA Clinical Guidelines. American Psychiatric Association. Practice guidelines for the treatment of patients with schizophrenia. 2004
    2. Falkai P et al. World J Biol Psychiatry 2005; 6: 132-191.
    3. Kendler KS et al. Arch Gen Psychiatry 1996; 53: 1022-1031.
    4. World Health Organization. The World Health Report: 2001: Mental health: new understanding, new hope.
    5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Edition Text Revision (DSM-IV-TR). Arlington: American Psychiatric Publishing Inc. 2000.
    6. Lieberman JA et al. J Clin Psychiatry 1996; 57(suppl 9): 5-9.
    7. Breier A et al. Am J Psychiatry 1994; 151: 20-26.
    8. Robinson DG et al. Am J Psychiatry 1999; 156: 544-549.
    9. National Institute for Clinical Excellence. National Clinical Practice Guidelines Number 82.
    10. Howard R et al. Am J Psychiatry 2000; 157: 172-178.
    11. Angermeyer MC et al. Schizophr Bull 1990; 16: 293-307.
    12. Murray RM and Fearon P. J Psychiatr Res 1999; 33: 497-499.
    13. Lang UE et al. Cell Physiol Biochem 2007; 20: 687-702.
    14. Harrigan SM et al. Psychol Med 2003; 33: 97-110.
    15. Bottlender R et al. Schizophr Res 2003; 62: 37-44.
    16. Lynn Starr h. et al: Comparison of long-acting and oral antipsychotic treatment effects in patients with schizophrenia, comorbid substance abuse, and a history of recent incarceration: An exploratory analysis of the PRIDE study; Schizophr Res. 2018 Apr;194:39-46. doi: 10.1016/j.schres.2017.05.005. Epub 2017 Jun 7
    17. Awad AG et al. Pharmacoeconomics 2008; 26: 149-162.
    18. Keith SJ et al. Psychiatr Serv 2004; 55: 997-1005.
    19. Lieberman JA et al. Pharmacol Rev 2008; 60: 358-403.
    20. Tandon R et al. Psychoneuroendocrinology 2003; 28(suppl 1): 9-26.
    21. Wyatt RJ. Schizophr Bull 1991; 17: 325–351
    22. Robinson DG et al. Arch Gen Psychiatry 1999; 56: 241-247.
    23. Weiden PJ et al. Psychiatr Serv 2004; 55: 886-891.
    24. Koen L et al. Psychosomatics 2007; 48: 128-134.
    25. Novick D et al. Psychiatry Res 2010; 176: 109-113.
    26. Kozma CM et al. Changes in schizophrenia-related hospitalization and ER use among patients receiving paliperidone palmitate. Current Medical Research and Opinion. 2011.27;1603-1611

show more