Treatment of schizophrenia should not be limited to drugs, says WHO

Treatment of schizophrenia should not be limited to pharmacotherapy but should also include psychosocial interventions, says the World Health Organization (WHO).

Mohammad Taghi Yasamy, senior medical officer at WHO’s department of mental health and substance abuse, said such interventions can also help prevent some of the side effects of antipsychotic medications.

Many antipsychotic medicines increase appetite and, if not monitored regularly, can lead patients to develop diabetes. “Diabetes among these patients was two to three times more common than the general public,” Yasamy said, adding that they also developed hyperlipidaemia, where the blood fat increased and patients developed cardiovascular diseases.

Overall, the life expectancy of people with schizophrenia is 10-25 years shorter than the general population. According to Yasamy, there are many reasons for this, including poor lifestyle, being overweight, smoking — which was 2-3 times more common among people with schizophrenia — and lack of physical activity.

However, with regular monitoring of physical health, and by tackling the side effects of medicines, people with schizophrenia could have a more normal life, says WHO.

Yasamy said the global agency believes there also needs to be a shift “from institutions to community services”.

An estimated 21 million people worldwide are suffering from schizophrenia, comprising 12 million males and 9 million females, but only about 50% are receiving services. In low- and middle-income countries, “the services gap is higher”, Yasamy said. He emphasised that the situation is generally worse in Africa in terms of services, where about 80% of people with mental illness do not receive any services for mental disorders.

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Citation
The Pharmaceutical Journal, October 2014;Online:DOI:10.1211/PJ.2014.20066840