Psychiatric Rehabilitation for Schizophrenia

Schizophrenia is a stress-related, neurobiological disorder characterized by disturbances in the form and content of an individual's thought and perceptual processes, affect and social and instrumental role behavior. The pervasive impact of schizophrenia across perceptual, cognitive, emotional and behavioral domains, as well as the heterogeneity within those domains require a multimodal and comprehensive approach to treatment and rehabilitation which involves the individual and his or her environment. A multidimensional and interactive model that includes stress, vulnerability, and protective factors best guides the types of interventions for treating and rehabilitating persons with schizophrenia. The practical significance of the stress-vulnerability-protective factors model of schizophrenia lies in the guidelines it offers to clinicians. Medications buffer the psychobiological vulnerability and underlying biochemical disturbance; training in problem solving and social and independent living skills promotes the development of personal competence and thereby strengthens the individual's protection against stress and vulnerability; supportive services (e.g., case management, housing, social service entitlements, supported employment) compensate for the individual's residual symptoms and deficits in functioning independently. An integrated approach that incorporates early detection and treatment of schizophrenia symptoms, collaboration between patients and caregivers in managing treatment, family and social supports, and training in social, instrumental and coping skills has been documented to improve the course and outcome of schizophrenia as measured by symptom recurrence, social functioning, and quality of life.