For most people, when they feel under the weather they can just run to their local pharmacy and grab some over-the-counter medication to relieve their symptoms. If it persists, an appointment with their primary healthcare provider usually ends with them getting a prescription for a more powerful medication. However, the end result is almost always the same: they gain satisfaction. The feeling of almost bliss and harmony that marks the end of a period of illness is something many people can attest to. However, this cycle of being healthy, falling ill, and then regaining your health is not as simple when the illness is one that affects the mind. The unpredictable nature of some mental illnesses can lead to a decrease in quality of treatment someone with said illnesses will receive. For instance, schizophrenia spectrum disorder’s affected population faces these hardships constantly.
The term schizophrenia spectrum disorder is really just a broad brush grouping of similar illnesses which include but is not limited to: schizophrenia, schizoaffective disorder, schizophreniform disorder, and schizotypal personality disorder (Barch, 2010). While these illnesses do share similarities in terms of the symptoms that are present, they are not identical. With that being said, people with a disorder on the schizophrenia spectrum do share similar obstacles when trying to get treatment.
One of these obstacles is treatment adherence. A common issue reported by medical professionals is that people with schizophrenia spectrum disorder often have shown lack of insight. This lack of insight pertains to their inability to grasp the idea that they have a mental illness and in turn will cause them to not adhere to any medication that is prescribed by their healthcare provider. While that does play a role in treatment adherence, another factor is what kind of delusions or hallucinations people are experiencing. One article describes treatment adherence to be poor in people who experience grandiose delusions. This is attributed to the fact that the medication causes a reshaping of one’s self image to one that isn’t as spectacular as they once thought (Schizophrenia Treatment Challenges, 2020).
Another obstacle is the psychosis relapse common in people undergoing assured antipsychotic treatment. Psychosis relapse is defined as “the recurrence of previously treated psychotic symptoms” (Sandy, 2013). The go-to explanation for this is poor medication adherence, as mentioned previously. The data of one massive systemic review showed that patients who were classified with prospective symptom remission (PSR) had a lower percent chance of undergoing a psychosis relapse in comparison to patients who did not show PSR. This could be interpreted as patients who “truly wanted help” seemed to take the medication as prescribed and had a lower chance of experiencing a psychosis relapse. However, the rest of the data from that same study doesn’t support the conclusion, as a risk for relapse was shown to be heavily linked to tardive dyskinesia (Psychiatry Advisor, 2020). This condition causes repetitive, involuntary movements and often results from long-term use of antipsychotic medication. Therefore, context is needed to truly understand why a certain population possibly stopped taking their medication as prescribed. Could it be that they suffered physical symptoms that were too much to bear and decided they felt better off of the medication?
People’s largest obstacle in getting treatment for schizophrenia spectrum disorder is the chance of developing a co-occurring disorder, such as alcohol use disorder (AUD). The main reason that scientists believe this co-occurrence develops is the drive for some people to self-medicate with alcohol or other substances. However, whatever the reason may be for the co-occurrence, it’s detrimental effects on the person is seen in the sudden drop in available treatment options. Many of the treatments given to people with schizophrenia spectrum disorder are built around the administration of antipsychotic medication to help the person with their delusions and hallucinations. An obvious conflict arises when a patient is seen to have schizophrenia spectrum disorder and AUD because a medical professional cannot in good faith prescribe medication to someone who is seen to abuse alcohol due to the fact that the consumption of alcohol with prescription medication can cause life threatening issues. Therefore, the medical professional has to figure out a treatment plan that excludes the use of prescription medication or try and help the person overcome their battle with alcohol (Drake & Mueser, 2002).
Despite all of the medical advances that have come out throughout the years, mental illnesses are still extremely difficult to treat. Understanding that treatment plans for people with mental illness are unique to the individual is crucial for grasping the complex nature of such ailments. As was discussed through this piece, there are a number of obstacles that can arise for each person that alters what treatment works for them. It is essential to know that, for these people, it is an ongoing battle, which is better served when they have a support system around them that recognizes it is a lifelong marathon and not a race to be “cured.”
Barch, D. M. (2010). Schizophrenia Spectrum Disorders. Noba. https://nobaproject.com/modules/schizophrenia-spectrum-disorders#:~:text=The%20spectrum%20of%20psychotic%20disorders,substance%20use%20or%20medical%20conditions.
Schizophrenia Treatment Challenges. (2020). Psychiatric Times. https://www.psychiatrictimes.com/view/schizophrenia-treatment-challenges
Psychiatry Advisor. (2020, September 16). Psychosis Relapse Common During Assured Antipsychotic Treatment – Psychiatry Advisor. Psychiatry Advisor. https://www.psychiatryadvisor.com/home/topics/schizophrenia-and-psychoses/psychosis-relapse-common-during-assured-antipsychotic-treatment/
Sandy. (2013, May 14). Psychotic relapse. NeuRA Library. https://library.neura.edu.au/schizophrenia/illness-course-and-outcomes/psychotic-relapse-2/#:~:text=What%20is%20psychotic%20relapse%3F,social%20support%20and%20stress%20reduction.
Drake, R. E., & Mueser, K. T. (2002). Co-Occurring Alcohol Use Disorder and Schizophrenia. Alcohol Research & Health, 26(2), 99–102. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683824/