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Understanding Schizophrenia

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Getting It Right With Dr Boles

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Schizophrenia is a brain disorder that shows up in 1%-3% of American population. This disorder is clinically manifested by psychosis (hearing voice, seeing what is not there, delusive thinking) and cognitive malfunction (antisocial behavior, illogical actions and confusion). Symptoms typically emerge in adolescence and early adulthood (peak age for males is 20 and 25 for females). The symptoms show a pattern of worsening then remissions finally manifesting as a chronic state of residual symptoms and functional impairment.

The annual cost of schizophrenia in the United States is approximately 60 billion dollars, including direct medical cost, non-health care costs and lost productivity. Numerous studies have shown that longer the duration of the initial episode of illness peior to treatment intervention is associated with poorer treatment response and outcome.There is a progression in brain abnormality and reduction of  "gray " matter.

Subgroups of individuals diagnosed with schizophrenia may experience only limited disability or have positive outcomes in spite of substantial symptoms. Coping skills, peer and family support contribute to the stablization of the symptoms expressed.

Pharmacologic treatment of schizophrenia targets reducing symptoms and preventing relapse. However, in the United States, psychosocial and recovery-oriented services have not been available to patients with first-episode psychosis. Comprehensive services for patients with early-stage psychosis are being implemented in Australia, Europe, Canada and Asia at a more rapid pace than in the United States. An important reason for the slow US adoption of this treatment model is a lack of adequate financing. Health insurance does not pay for psychosocial and rehabilitative services recommended for individuals in the earliest stages of psychosis. Current public health facilities favor assisting individual with chronic disabilities.

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