The Clinique du Château de Garches admits patients suffering from schizophrenia. This diagnosis, which was for a long time considered to be very serious, is no longer so pejorative. Schizophrenia can be of varying degrees of intensity, going from relatively benign to acute forms. This is a frequent affliction since it affects 1 % of the population.
A stay in the clinic must correspond to three objectives :
Hospitalisation may be decided upon to treat one phase of the illness for which out-patient medical treatment is no longer adapted.
Treatment includes counselling, social support and rehabilitation. In addition anti-psychotic medicines are available to treat the worst symptoms of the illness, such as hallucinations, but there is no "cure" at present. Treatment now includes a whole set of therapeutic, medicinal and psychological means that are better tolerated than hitherto and which can attenuate the consequences of the illness.
Many symptoms, to do with thought processes (delirium), perceptions (hallucinations), emotions and affection (autistic withdrawal), social behaviour (withdrawal, isolation), care of one’s person (negligence), motricity (agitation, catatonia), may convey schizophrenia. These manifestations may appear all of a sudden or progressively. The clinical picture, i.e. the grouping of these symptoms in a given picture, is particular to each individual and may also change in the course of time for one individual; which renders the diagnosis even more difficult. In order to establish a diagnosis of schizophrenia and eliminate other possible causes causing the perturbations, one often has to have recourse to well developed clinical evaluation, psychological tests, brain imagery and biology. The Clinique du Château de Garches has the technical means available enabling these investigations to be carried out in a very short space of time.
The treatment of schizophrenia comprises three parts: medicinal, psychological and social. There are numerous narcoleptics, antipsychotics, antidepressants and tranquillisers which may bring remission of the symptoms. They different in respect to their efficiency, tolerance and are prescribed according to the particular characteristics of the illness. Nowadays we dispose of very powerful medicines.
The doctor looks for and evaluates together with each patient the treatment which has the best benefits versus risks ratio, i.e. the treatment which enables the best improvement with the lowest possible side effects. This procedure keeps the amount of medication prescribed to a minimum.
In certain cases, a treatment which becomes less efficient or of which the disadvantages become too important, must be stopped, under medical surveillance and replaced by molecules which are better tolerated and sometimes more recent. The decisions for putting in place or modifying treatment are made in cooperation with the patient’s personal psychiatrist who will continue treatment after the patient returns home.
The psychological examination of the patient suffering from schizophrenia is essential. In the Clinique du Château de Garches, this consists in daily meetings with a psychiatrist (7 psychiatrists for 44 patients), in the progressive participation in physical activities (psychomotricity and relaxation), in artistic workshops animated by psychologists and ergotherapists, and in exchange and information groups. If this is not already underway, psychotherapy may be organised upon departure.
Over the last twenty years research concerning the cerebral and environmental causes as well as the mechanisms of this affliction has made rapid progress and leaves hope for further improvements in the methods of treatment and the possibility of preventive measures. Advances made in understanding have modified the attitude of the medical experts towards schizophrenia and also without doubt in the eyes of the public, even if this evolution is somewhat slower. Consequently, to increase participation in the curing process and improve the chances of success, patients are now informed about the diagnosis. This stage can be touchy since many subjects suffering from schizophrenia have difficulties accepting the idea that they may be ill.
Despite the progress made in therapeutic methods which overall reduce the need for hospitalisation, there may be for certain patients, times of crisis which render hospitalisation mandatory. A peaceful, warm, professional environment, like the Clinique du Château de Garches, will therefore attenuate the intensity of the patient’s suffering or make up for the momentary impossibility of an autonomous life outside.
