ARI SHAPIRO, HOST:
A major new study may change the way the U.S. treats schizophrenia. Until now, the standard prescription was powerful drugs, which sometimes have intense side effects. Now researchers recommend a range of interventions, including low dosage drugs, talk therapy, family involvement and supported employment or education. They also say early intervention is key. Dr. Nina Schooler is a co-author of the study and joins us to discuss it. Welcome to the studio.
NINA SCHOOLER: Thank you, pleasure to be here.
SHAPIRO: Let's start with the early intervention part. Why would people benefit more from having this combined treatment shortly after their first schizophrenic episode than having it years after their first episode?
SCHOOLER: Well, the study was focused on people who were in their first episode. And what we found was that for those people who'd been ill less than 74 weeks before they first received treatment, the coordinated specialty care package provided more benefit in terms of reduction of symptoms and improvement in social functioning.
SHAPIRO: Why do you think that is, that people who are ill for a shorter period of time would show more benefit from this treatment?
SCHOOLER: What appears at least to me to be the case is that when people have been ill for a shorter period of time, they're better able to mobilize resources that they need in order to benefit from all of the parts of the treatment program that we offered.
SHAPIRO: This combined package of treatment which involves family, education, employment, talk therapy, seems in some ways less jarring and intrusive than powerful drugs. But it also seems like it would be difficult to coordinate. It requires many different stakeholders to get involved.
SCHOOLER: It does. It requires the development of a treatment team and the ability of that team to work together. Talking therapies are not an alternative. They're combined with medication, offered in low doses, which are what people early in the illness really need.
SHAPIRO: And ultimately is the hope that people with this illness, if they get the kind of treatment you're recommending, will be able to function no differently from any other member of society, or will they still experience hallucinations, delusions and just recognize that the voices in their head are not voices they should follow?
SCHOOLER: Well, for some people, the goal of full recovery is a possibility. For others, learning how to manage symptoms, keep them under control and deal with life experiences is going to be the root. And the important thing is that having the support of a team and the support of family can make such a large difference.
SHAPIRO: How difficult do you think it will be to make the treatment that you recommend the standard treatment for people with schizophrenia in the United States?
SCHOOLER: There have been astonishing moves in that direction so far with mental health grants that are provided by the government to the states, including set-aside money specifically designed to implement these kinds of treatment programs. Is this kind of coordinated specialty care available for every patient who develops a psychotic illness in the United States now? No. Do I think it can happen in the future? Yes.
SHAPIRO: That's Dr. Nina Schooler, a co-author of a new study that may change the way we treat schizophrenia in the United States. Thanks for joining us.
SCHOOLER: Thank you.
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