Abstract: Recovery and normalized psychosocial functioning are the main targets for the treatment of schizophrenia. However pharmacological treatments are not good enough to achieve recovery in schizophrenia. Treatment of schizophrenia and recovery issues are under discussion. Only 10-20 % of all schizophrenia patients achieve full remission of symptoms and good psychosocial functioning during long term treatment of schizophrenia. Positive and negative symptoms are main symptom clusters to treat. Negative symptoms are strongly correlated to cognitive functions whereas both negative symptoms and cognitive dysfunctions predict the patient’s ability to work and function independently at the society. But antipsychotics have limited benefit for improving cognitive functions and negative symptoms.
Meta-analytic studies and latest multi center, large scale studies such as CATIE and EUFEST have found that Clozapine, despite its limited use, seemed to be superior compared to all other antipsychotics regarding efficacy in schizophrenia and Olanzapine was associated with significantly longer time to discontinuation although both were significantly associated with metabolic and severe side effects. One of the important results driven from the CATIE trial has shown that the majority of the patients in each antipsychotic treatment group had discontinued their first treatment due to either inefficacy over schizophrenia symptoms or intolerable side effects. Recovery issues in schizophrenia result in polypharmacy as using more than one antipsychotics at the same time. However schizophrenia patients have higher mortality rates. Mortality rate is about two times greater and life expectancy is 20% shorter than general population in schizophrenia mainly due to cardiovascular and metabolic side effects which affect patient’s satisfaction with treatment and let nonadherence to treatment.
Advances in our understanding of the etiology, course, and treatment of schizophrenia have led to an increased awareness of the need for defined standards against which to judge clinical improvement, both in clinical trial settings and in daily practice. What we regard as success in treating schizophrenia has evolved substantially, from reducing the risk of harm to self and others, through control of positive (and more recently negative) symptoms, towards preventing relapse and achieving improvements in daily functioning. Remission of schizophrenia symptoms does not always mean to have recovery from the illness. Recovery needs to improve cognitive functions, subjective well-being, quality of life and psychosocial functioning.
Today pharmacotherapy alone is not enough to achieve recovery, therefore psychosocial interventions should be established and be integrated with antipsychotics. However it is not clear which type of psychosocial treatment is best. The most important one is psychoeducational program that has been shown that it may enhance treatment adherence and reduce relapses in schizophrenia. Psychosocial intervention programs that may integrate cognitive, behavioral, educational and psychotherapeutic aspects need to be developed.

Brief Biography of the Speaker:
Koksal Alptekin has has been practicing as professor at the Department of Psychiatry of the University of Dokuz Eylul, Izmir-Turkey since 2002. He had residency training in Psychiatry at the same department. He had been trained in Psychodrama and Psychoanalytically Oriented Group Psychotherapy. Besides many national professional organizations he is a Schizophrenia and Epidemiology Section member of European Psychiatric Association (EPA). He has participated in the task force of WPA for schizophrenia since 2005. He is one of the editors of “Schizophrenia Treatment Guideline” and “Schizophrenia” published by Scizophrenia Section of Turkish Psychiatric Association. Dr. Alptekin's main research focus and publications include psychopharmacological treatment of schizophrenia, cognitive dysfunctions and quality of life in schizophrenia. Nowadays his research interest has been moved towards genetics and epidemiology of schizophrenia.