About half of people with schizophrenia don’t believe they are ill and don’t want treatment.
Dr. Sanjay Gupta interviews Robert Cotes, MD, Emory University School of Medicine
Sanjay Gupta, MD, Everyday Health: How hard is this on families? What do families have to do in order to get their loved ones treatment?
Robert Cotes, MD, Emory University School of Medicine: It’s a real challenge for
families. I have heard a lot of people say that they are at the end of their
Dr. Gupta: Is it a question of violence? Is there violent behavior related with
Dr. Cotes: People with schizophrenia aren’t any more dangerous than anyone in the
general population. Oftentimes, people with schizophrenia are very fearful that
something is going to happen to them.
Dr. Gupta: So what is it that ultimately pushes the family over the brink then?
Dr. Cotes: They have almost gotten to the point where they don’t even want to take
care of their loved ones any more just because of the years and years of
suffering that they have had. So I think that the disease can sometimes really
pull families apart.
Dr. Gupta: Is it a progressive thing? I mean, is it going to get worse over your
Dr. Cotes: We have a current belief that psychosis is most likely toxic to the
brain, and that the longer one is psychotic the more difficult it is to treat. The
key is to reduce the duration of untreated psychosis. So we really want to get
people into treatment quickly, get medications on board, get psychosocial
supports on board, and I think that that helps the long-term prognosis.
Dr. Gupta: You know, in medicine we like to do as much as we can for patients. With
patients with schizophrenia they are difficult to treat. How challenging is
this field for you.
Dr. Cotes: Probably around 50 percent or so have pretty good prognosis with
medications and with the right treatment. So although I think people with
schizophrenia have a reputation that they are difficult to treat, they are
actually a group of people that are very responsive to treatment. Sometimes
family members think that their loved ones may be lazy or just not motivated
when in fact it’s a symptom of the illness that people can get education for.
Last Updated: 07/14/2014