Combined minimal medication and psychosocial interventions in acute-phase schizophrenic psychosis : knowledge, attitudes, and practices of psychiatrists in South Africa.

Abstract

Combined minimal medication and psychosocial interventions in acute-phase schizophrenic psychosis are seen by many as the way to address the problems inherent in the use of antipsychotic medication as the mainstay treatment for schizophrenic psychosis. This research report explores the Knowledge, Attitudes, and Practices of South African psychiatrists working in public hospitals with regard to these alternative interventions. Eight psychiatrists were interviewed using a selfdesigned semi-structured questionnaire consisting mostly out of open-ended questions. A qualitative approach was adopted, while thematic content analysis was used to identify themes that address the aims of the research. Analysis revealed that: None of the participants had any in-depth knowledge of combined minimal medication and psychosocial interventions in acute-phase schizophrenic psychosis, while one participant was aware of their existence; The participants were unanimously opposed to the use of psychological interventions in acute-phase schizophrenic psychosis, as medication is viewed as the mainstay in treatment, with psychosocial and psychological interventions seen only as an adjunct, and contraindicated in the acute phase; Schizophrenia is viewed as a biological disorder; The majority of participants were not willing to minimize or withhold medication, as psychosis is seen as toxic to the brain, while one participant did report delaying medication in cases where there was uncertainty around diagnosis; The lack of resources in South African mental health care greatly influences treatment approaches.