Friday, April 29, 2005

Treatment-Resistant Schizophrenia: An Expert Interview With Ralph Hoffman, MD Interview in Medscape Psychiatry and Mental Health - " Treatment resistance used to refer more to the positive symptoms, like hallucinations and delusions, that would persist despite reasonable trials of antipsychotic medicine. And incomplete recovery is, for schizophrenia, kind of a misnomer, because basically schizophrenia in essence is almost defined by the incompleteness of recovery. So if people go into full remission of all of their symptoms, it actually raises questions about the diagnosis. But the typical hoped-for course these days is that the medication, and whatever other treatments they're given, result in the patient's positive symptoms going into relatively full remission. But in general, for these patients, they continue to have residual negative symptoms. So their concentration may be somewhat off and they may continue to be somewhat more socially isolated and withdrawn, less able to engage in work or school kinds of activity. That's really more the norm, unfortunately. There are different levels of incompleteness of recovery, so that oftentimes we'll see patients who have a temporary remission, but then the symptoms quickly come back within a year or so, and the negative symptoms get worse, so the patient becomes even more progressively withdrawn. And so those are the kinds of trajectories of incomplete recovery." [Viewing Medscape resources requires registration, which is free].