Management of psychotic disorders requires the integration of pharmacotherapy with psychosocial interventions (Lieberman et al. 2005). A variety of psychosocial treatments can enable a patient to acquire social and vocational skills and to manage residual psychotic symptoms.
These psychosocial interventions include: • Individual/group therapy
• Psycho-education
• Cognitive behavioral therapy (CBT)
• Social skills training
• Family intervention
• Cognitive remediation
• Arts therapy
• Adherence therapy
• Psychodynamic psychotherapy
Successful treatment of psychotic disorders requires the integration of medical, psychological, and psychosocial therapies by a multidisciplinary team. Psychosocial rehabilitation and patient and family education
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• Patients should be informed of the side effects of antipsychotic medications, (e.g. involuntary movements, akathisia), as non-compliance is more likely otherwise.
• Stimulant drugs (amphetamine, levodopa) should be avoided, as they can precipitate psychosis.
• Antipsychotics often produce emotional blunting, apathy, or Parkinsonian symptoms, which may be misidentified as negative symptoms; raising the dose in these cases can worsen side effects.
• Patients with schizophrenia have a 5% lifetime risk of suicide (Lehman et al. 2004).
• Full recovery from schizophrenia is rare, and symptoms usually follow a waxing/waning course (Stahl 2011).
• Poor prognosis is associated with early onset of disease and family history of schizophrenia (Gabbard 2007).
• Antipsychotics can reduce the positive symptoms of psychosis in 7-14 days, but they do not have much effect on negative symptoms or cognitive dysfunction (Lehman et al. 2004).
• Typical antipsychotics are linked to a higher rate of extrapyramidal symptoms (EPS); however, atypical antipsychotics often produce weight gain, diabetes, and a higher risk of metabolic