Drug and Psychosocial Treatment Interactions in Schizophrenia

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Abstract
In a stress-diathesis approach to schizophrenia, stressful environmental events combine with pre-existing biological and psychosocial vulnerability to produce intermediate states of sensory overload, hyperarousal, and impaired processing of social stimuli. If untreated, these intermediate states often lead to the development of psychotic symptoms or relapse. In this approach assumes an interaction between biological and environmental etiologies and between biological and psychosocial forms of treatment. Evidence from studies which have examined the effects of both treatment strategies in tandem indicates that comprehensive treatment programs for schizophrenic patients should combine drug and psychosocial treatments. For outpatients, behaviorally oriented social skills training and family interventions are especially effective when added to neuroleptic drug therapy. A comprehensive approach to the clinical management of schizophrenia can be described in terms of a clinical decision tree, in which patient characteristics and treatment needs provide a rational basis for the application of a range of psychosocial and neuroleptic drug interventions in a variety of treatment settings.