Integration of Pharmacological and Psychosocial Treatment for Schizophrenia in Mexico: The Case of a Developing Country Proposal

For decades, schizophrenia was considered exclusively as a biological disorder. As a result, pharmacotherapy has been considered as the predominant mode of treatment. Antipsychotic medication is indicated for first episode, acute, chronic as well as for refractory patients. So much research has been conducted to evaluate the efficacy of antipsychotics through clinical studies, randomized controlled trials and meta-analyses. Scientific journals are full of research on pharmacotherapy. According to the American Psychiatric Association [APA] (2004), a treatment plan for patients with schizophrenia should include: 1.The reduction or elimination of symptoms, 2.Improving quality of life and adaptive functioning, and 3.Promote and maintain recovery. In the last decades, research in the social sciences and psychiatric rehabilitation has produced a considerable body of knowledge with respect to psychosocial factors that influence the curse of this illness. As a result psychosocial treatments have also been designed and implemented. With the beginning of the new century and after more than 60 years of research, there is a consensus that biological, psychological and social factors play a very important role in understanding and treating schizophrenia. Hence, the biopsychosocial model has been considered as the most comprehensive treatment approach for this illness. The treatment of schizophrenia has been the focus of changes since the introduction of neuroleptics in the 1950 s which initiated the transition from mental hospitals to the community, with long-stay patients confined in mental institutions going through the deinstitutionalization process, to the new millennium where the majority of them are actually living in the community. A considerable effort has been carried out in recent years to articulate the scientific basis of the treatment for people with schizophrenia. As a result evidence based treatment for schizophrenia has recommended that all persons with schizophrenia should receive the combination of: 1) optimal dose of antipsychotic medication, 2) psychosocial interventions, 3) psychoeducation for patients and carers as well as family therapy, and, 4) assertive homebased management to help prevent and resolve various issues such as: crises, relapse, medication adherence, etc, (Drake et al., 2009; Falloon et al., 2004; Fenton & Schooler, 2000; Lehman & Steinwachs, 2003; Shean, 2009; Thornicroft & Susser, 2001). In summary, scientific