Schizophrenia: Effective Treatment Relies on Medications, Empathetic Providers (Podcast)

Schizophrenia is a severe, chronic condition that affects the physical and mental well-being of millions worldwide. Its neurobiological underpinnings typically result in delusions, hallucinations, disorganized speaking and movements, and negative symptoms. Unfortunately, persistent misconceptions about how to approach these vulnerable patients can further complicate their prognosis.

“My wish is for people to look at those with schizophrenia as not scary, but scared," says Cleveland Clinic psychiatrist Amanda Horrigan, MD. “They're frightened — and most of the time, no one listens to them. [Our] ability to support and be empathetic doesn't cost anything, and it's incredibly powerful. Having that type of relationship with a patient actually helps their prognosis.”

In the latest episode of Cleveland Clinic’s Neuro Pathways podcast, Dr. Horrigan discusses how to best meet the complex needs of individuals with schizophrenia. She covers:

• Diagnosing schizophrenia
• Frequent presentations and chief clinical features
• Current pharmacological treatment options
• Managing patients with empathy
• Connecting patients and their families with appropriate support networks

Click the podcast player above to listen to the 20-minute episode now, or read on for a short, edited excerpt. Check out more Neuro Pathways episodes at clevelandclinic.org/neuropodcast or wherever you get your podcasts.

This activity has been approved for AMA PRA Category 1 Credit™ and ANCC contact hours. After listening to the podcast, you can claim your credit here.

Podcast excerpt

Podcast host Glen Stevens, DO, PhD: [Let’s say] I come in, and you give me a diagnosis of schizophrenia. What are you going to do for me? What's my next step?

Dr. Horrigan: Antipsychotic medication is the mainstay treatment for whatever symptoms you're experiencing – but even before that, I cannot emphasize enough [how important it is] to develop a therapeutic alliance with this person. The hardest part of schizophrenia is that many patients lack insight into the fact that they even have an illness. [Their hallucinations and delusions] are very real to them, and you're asking them to take this medication with all these side effects for an illness they don't believe they actually have. It’s essential to build trust. If a person…is having such distress that they cannot sleep because they're looking out their window repeatedly, believing someone is out there, you can say, “That sounds terrible. Can I help you with that?” [You can help them find ways to] get some sleep and reduce their anxiety. Trying to convince them that what they're experiencing is not real will just shut down the entire conversation about treatment.