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

Valencia, Marcelino Hernández; Díaz, Alejandro; Juárez, Francisco

doi:10.5772/34618

Cited by 7 publications

(5 citation statements)

References 122 publications

(107 reference statements)

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“…This study aimed to investigate the possible protective effect of iso avones against involuntary movements induced by haloperidol in rats and the role of proin ammatory cytokines in this process. In clinical practice, treatment of extrapyramidal side effects (akathisia, tremor, parkinsonian stiffness, bradykinesia and TD) associated with the use of antipsychotics is generally performed with anticholinergic drugs such as biperiden (Reynoso et al 2012;Valencia et al 2012). However, these medications causing anticholinergic side effects (tachycardia, mydriasis, dryness of the mucous membranes and urinary retention), and there is some evidence that anticholinergic medications can increase the positive symptoms of schizophrenia (Ocaña-Zuritaet et al 2016).…”

Section: Discussionmentioning

confidence: 99%

Reversal of haloperidol-induced orofacial dyskinesia and neuroinflammation by isoflavones

et al. 2021

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Schizophrenia is a serious mental illness, and its pharmacological treatment consists in the administration of antipsychotics, such as haloperidol. However, treatment with haloperidol often causes extrapyramidal motor disorders such as tardive dyskinesia (TD). TD is a movement disorder characterized by involuntary movements, which can be studied in animals. So far, there is no effective treatment for TD and alternatives have been sought. Thus, the objective was to evaluate the possible protective effect of iso avones against the induction of involuntary movements induced by haloperidol in an animal model. Male Wistars rats were treated with haloperidol (1 mg/ kg/day) and/or iso avones (80 mg/kg) for 28 days. Rats were submitted to behavioral evaluation to quantify vacuous chewing movements (VCM) and the locomotor activity. In addition, the levels of pro-in ammatory cytokines were measured in the striatum. Haloperidol treatment reduced the locomotor activity and increased the number of VCM in rats. Co-treatment with iso avones was able to reverse hypolocomotion and reduce the number of VCM to the levels of the control group. Besides, haloperidol caused signi cant increase in the proin ammatory cytokines (interleukin-1β:IL-1β, tumor necrosis factor-α:TNF-a and IL-6 and the cotreatment with iso avones was able to reduce the levels of IL-1β and TNF-α, but not IL-6. It is believed that the bene cial effect found with this treatment is related to their anti-in ammatory potential and also to the action on estrogen receptors (based on ndings in the scienti c literature). Finally, further studies are needed to elucidate the mechanisms of iso avones in reducing motor disorders induced by antipsychotic.

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Section: Discussionmentioning

confidence: 99%

Reversal of haloperidol-induced orofacial dyskinesia and neuroinflammation by isoflavones

et al. 2021

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“…Psychoeducation program: This program was designed as an intervention that could be provided alongside the first line of treatment i.e., psychotropic medication. This psychoeducation program was based on cognitive behavior therapy to educate, guide, motivate and developing insight in patients about the problem (Valencia et al, 2012). Another focus of this program was to treat patients' dysfunctional beliefs, cognitive distortions, and impaired motivation (Yesilyaprak et al, 2019).…”

Section: Interventionsmentioning

confidence: 99%

“…As it is mentioned above, antipsychotic drugs are the first choice of treatment but medication compliance is a big issue as it has been observed on other studies that around 30-40% patients respond poorly to medication because of a lack of adherence to the prescribed drug therapy (Nawaz et al, 2020). The medication non-compliance could be due to a lack of combined approach to treatment i.e., combining pharmacotherapy with psychosocial intervention, supportive therapies, rehabilitation, and awareness programs (Valencia et al, 2012). Therefore, psychoeducation program was added as a supportive intervention to enhance the pharmacotherapy treatment adherence in this study.…”

Section: Interventionsmentioning

confidence: 99%

Attitude towards Mental Help-Seeking, Motivation, and Economic Resources in Connection with Positive, Negative, and General Psychopathological Symptoms of Schizophrenia: A Pilot Study of a Psychoeducation Program

Abbas

Baig

Sadiq

et al. 2022

Preprint

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BackgroundPharmacological treatment is usually the first line of treatment for schizophrenia, but more strategies are needed to augment this treatment to promote better outcomes. It is known that adherence to pharmacological treatment in schizophrenia patients can be increased by working with their insight into their disorder. In literature, many programs have been found to increase mental help-seeking and reducing symptom severity but most are from the Western cultures and/or are conducted with people attending any institution (i.e., a university or an in-patient care unit) and with specific age ranges (i.e., young adults or older adults). However, in the noninstitutionalized population of different age groups of Pakistan, there is a need to find ways (alongside medication) that promote attitude toward mental help-seeking and reduce symptom severity. Therefore, the current pilot study was designed to investigate the impact of a psychoeducation program on increasing patients’ motivations and help-seeking attitudes toward treatment, reducing the severity of the symptoms, and the role of financial sources in the course of their illness.MethodologyIn this pilot study, we targeted diagnosed patients with schizophrenia disorder from different hospitals and primary care clinics. After eligibility screening, 255 participants were included, and 220 completed the psychoeducation program. Both men, 143(56.08%) and women, 112(43.82%) with marital statuses of being single 123(48.24%), married 98(38.43%) and divorced/widower/widowed 34(13.33%) were included. Respondents’ age range was 18-52 years (M=35.45, SD=10.27).ResultsFindings revealed that significant change in symptoms severity was observed after 16-weeks psycho-education program on positive symptoms (Md=21.05, n=220) compared to before (Md=25.00, n=220, z=-12.47, p=.000, ηp2= .59, negative symptoms (Md=15.74, n=220) compared to before (Md=17.44, n=220, z=-9.52, p=.000, ηp2= .45, and general psychopathological symptoms (Md=38.32, n=220) compared to before (Md=43.40, n=220, z=-12.72, p=.000, ηp2= .61. Similarly, on HSAT (Md=39.03, n=220) compared to before (Md=28.27, n=220, z=-10.43, p=.000, ηp2= .50, and PMFT (Md=5.69, n=220) compared to before (Md=4.85, n=220, z=-12.43, p=.000, ηp2= .59 respectively. Change in patients’ motivation after 16-weeks at low motivation level was -55(25%) (this category got reduced as people moved to better motivation levels), at moderate motivation level it was 10(4.55%) and at high motivation level it was 45(20.45%). Symptoms severity reduced in across all income groups but patients in low-income group tended to gain more from the psychoeducation programas compared to middle- and high-income group in both pre and post treatment.ConclusionIt is concluded that our psychoeducation program helps promote patients’ motivation and help-seeking attitude toward treatment, and helps reduces positive, negative, and general symptoms severity across all age groups and income groups. However, one of the limitations of this psychoeducation program is that it appears to be more advantageous for patients from low-income group as compared to middle- and high-income groups. However, this limitation can be considered a strength in a country like Pakistan where around 40% of the population lives in poverty. Usually, lower income groups tend to be worse off when it comes to treatment outcomes of any kind, but psychoeducation seems to be the avenue that appears different. Psychoeducation for schizophrenia should be explored further especially in poverty struck countries. Furthermore, the present research has opened way for an indigenous psychoeducation program for Pakistani schizophrenia patients that could potentially be used with all Urdu/Hindi speaking patients.Trial RegistrationThai Clinical Trial Registry (TCTR20210208003).

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“…Therefore, pharmacological and psychosocial advances have changed the therapeutic goals for this illness searching for the beneficial effects of integrating pharmacological and psychosocial treatment for these patients. [42][43][44][45][46][47][48][49][50][51][52][53] In a study in which Psychiatrists were questioned with regard to which strategies they would prefer for improving the psychosocial functioning of their patients with schizophrenia, they indicated, psychosocial treatment (46%), pharmacotherapy (26%), no specific strategy (6%), or (10%) did not respond, 70% of these patients had poor psychosocial functioning. 40 In schizophrenia, psychosocial functioning can be conceptualized as an early and chronic indicator of a disorder of neurodevelopment.…”

Section: Psychosocial Functioningmentioning

confidence: 99%

Cerebral, Psychosocial, Family Functioning and Disability of Persons with Schizophrenia

Valencia¹,

Medina²,

Calixto³

et al. 2022

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The human brain is the most cognitively capable of mammalian brains, endowed as it is with an overdeveloped cerebral cortex that, in parallel, renders it vulnerable to mental disorders. Schizophrenia is the expression of the dysregulation of the neuronal activity of cortical and subcortical regions due to modifications in the levels of the various neurotransmitters, especially of dopamine, with a reciprocal, intimate relationship among genes with environmental and psychosocial factors. If the dopaminergic system increases the function prefrontal cortex will be reduced: this is the main reason of social, occupational and familiar disruption. The present article describes the function of the brain in schizophrenia and its relation with anatomical, physiological, and genetic changes, in addition to identifying, psychosocial and family factors that can be determinant in the functionality of the patient. A review of national and international bibliography was conducted bearing in mind the following variables: functioning at the cerebral level; psychosocial functioning, familial functioning, disability, and functionality in persons with schizophrenia. Due to the variety of the issues included in this review, it can be concluded that schizophrenia is the product of a complex array of symptoms, deficits and disabilities. It was identified that there is a reciprocal confluence of diverse genetic, psychosocial, familial, environmental, educative, and social factors which affect the functionality of persons with this disorder. The latter makes it necessary to study the patient taking into consideration all of these components in an integral manner.

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

Cited by 7 publications

References 122 publications

Reversal of haloperidol-induced orofacial dyskinesia and neuroinflammation by isoflavones

Reversal of haloperidol-induced orofacial dyskinesia and neuroinflammation by isoflavones

Attitude towards Mental Help-Seeking, Motivation, and Economic Resources in Connection with Positive, Negative, and General Psychopathological Symptoms of Schizophrenia: A Pilot Study of a Psychoeducation Program

Cerebral, Psychosocial, Family Functioning and Disability of Persons with Schizophrenia

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