RESUMEN
The reciprocal balance between the cognitive normal awareness of reality and the cognitive psychotic awareness of reality in schizophrenia, is proposed, on the basis of the structural psychopathological theory of psychoses of the author. This balance points to the dominance of the operant conditioning of psychotic reality over normal reality during the invasion period of the disease, an equilibrium of both aspects during the steady period, and a dominance of normal reality during the residual period. A comprehensive program for secondary and terciary prevention of schizophrenia is outlined, with five levels of function delegation: D1, psychiatrists and psychologists; D2, nurses and social workers; D3, auxiliary nurses; D4, family co-therapist; D5, patients and other relatives. The functions delegated to D5 include the recognition of symptoms, causes and course, and attitudes conducing to secondary handicaps in patients. To D4, are delegate the administration of psychotropic drugs at home and technique for reinforcing normal reality. To D3, are delegated notions on epidemiology, the supervision of the psychopharmacological treatment and of reinforcement programs for normal reality, attitudes and its change, and notions of urgencies in psychosis. The D2 and D1 levels indicate treatment at all levels and treat the more complicated cases in institutions. The efficacy of the program in 36 cases, after a year, indicates a reduction of acute psychotic productivity from 72 to 6% of the patients, and a rate of hospitalization of only 8%.
Asunto(s)
Esquizofrenia/terapia , Adulto , Clorpromazina/uso terapéutico , Cognición , Femenino , Haloperidol/uso terapéutico , Humanos , Masculino , Métodos , Proyectos Piloto , Pronóstico , Esquizofrenia/rehabilitación , Psicología del EsquizofrénicoRESUMEN
The reciprocal balance between the cognitive normal awareness of reality and the cognitive psychotic awareness of reality in schizophrenia, is proposed, on the basis of the structural psychopathological theory of psychoses of the author. This balance points to the dominance of the operant conditioning of psychotic reality over normal reality during the invasion period of the disease, an equilibrium of both aspects during the steady period, and a dominance of normal reality during the residual period. A comprehensive program for secondary and terciary prevention of schizophrenia is outlined, with five levels of function delegation: D1, psychiatrists and psychologists; D2, nurses and social workers; D3, auxiliary nurses; D4, family co-therapist; D5, patients and other relatives. The functions delegated to D5 include the recognition of symptoms, causes and course, and attitudes conducing to secondary handicaps in patients. To D4, are delegate the administration of psychotropic drugs at home and technique for reinforcing normal reality. To D3, are delegated notions on epidemiology, the supervision of the psychopharmacological treatment and of reinforcement programs for normal reality, attitudes and its change, and notions of urgencies in psychosis. The D2 and D1 levels indicate treatment at all levels and treat the more complicated cases in institutions. The efficacy of the program in 36 cases, after a year, indicates a reduction of acute psychotic productivity from 72 to 6
of the patients, and a rate of hospitalization of only 8
RESUMEN
The reciprocal balance between the cognitive normal awareness of reality and the cognitive psychotic awareness of reality in schizophrenia, is proposed, on the basis of the structural psychopathological theory of psychoses of the author. This balance points to the dominance of the operant conditioning of psychotic reality over normal reality during the invasion period of the disease, an equilibrium of both aspects during the steady period, and a dominance of normal reality during the residual period. A comprehensive program for secondary and terciary prevention of schizophrenia is outlined, with five levels of function delegation: D1, psychiatrists and psychologists; D2, nurses and social workers; D3, auxiliary nurses; D4, family co-therapist; D5, patients and other relatives. The functions delegated to D5 include the recognition of symptoms, causes and course, and attitudes conducing to secondary handicaps in patients. To D4, are delegate the administration of psychotropic drugs at home and technique for reinforcing normal reality. To D3, are delegated notions on epidemiology, the supervision of the psychopharmacological treatment and of reinforcement programs for normal reality, attitudes and its change, and notions of urgencies in psychosis. The D2 and D1 levels indicate treatment at all levels and treat the more complicated cases in institutions. The efficacy of the program in 36 cases, after a year, indicates a reduction of acute psychotic productivity from 72 to 6
of the patients, and a rate of hospitalization of only 8
.