The evolving concept of Treatment-Resistant Schizophrenia

Schizophrenia is a chronic disease of body and mind that affects 1% of the population. The existence of the person with schizophrenia should be understood, at least, from two perspectives: one considering the integration of the individual into the social community, another understanding that there is a patient with a medical problem treatable with medications and psychotherapies. There is a large group of patients with 'treatment-resistant schizophrenia," that is, cases in which a minimum degree of remission with conventional treatments is not obtained. These cases have pointed to the fact that even today we still lack an integrative treatment model obtained through the assembling of specific interventions with verifiable effectiveness. The concept of treatment-resistant schizophrenia should have evolved in accordance with the advancing of the currently available knowledge and therapeutic resources. Why hasn't this happened? This article reviews the history of the concept of "resistance" to account for such failure and proposes a methodological approach to overcome this stagnation.