Théo Korchia: Improving The Treatment Of Schizophrenia

Théo Korchia: Improving The Treatment Of Schizophrenia

My name is Théo KORCHIA, and I am a French psychiatrist, particularly involved in the treatment of early-onset schizophrenic disorders. 

First of all, I'd like to thank the Schizophrenia International Research Society for honouring me with this prestigious award, as well as the Faculty of Medical and Paramedical Sciences at Aix-Marseille University (France) and the Assistance Publique des Hôpitaux de Marseille (APHM), which supported me and enabled me to spend a year at McGill University in Montreal. 

Schizophrenia is a pathology often shrouded in mystery and prejudice, which profoundly affects the lives not only of those who suffer from it, but also those around them. 

Management of the first psychotic episodes determines the outcome and prognosis of patients, and it is therefore necessary to improve it. Generally speaking, my work highlights the value of pharmacogenetics, adapting and personalizing the antipsychotic treatment to different genetic profiles for greater efficacy. Consequently, various side-effects of antipsychotic therapy, notably sexual dysfunction which is very disabling and leads to discontinuation of treatment, are drastically reduced. Patient motivation must also be strengthened by including them in therapeutic decisions to improve overall quality of life. 

A particularly innovative aspect of my work concerns the impact of sexual dysfunction in patients suffering from schizophrenia. This issue, which has long remained on the fringes of psychiatric research, is crucial to patients' quality of life. Sexual dysfunction can be both a symptom of the illness and a side-effect of treatment, making it a dual challenge to overcome. 

My perseverance on this issue has led to the publication of a meta-analysis of over 21,000 patients worldwide, in the journal JAMA Psychiatry. 

Our study reveals with edifying clarity the high frequency of sexual dysfunction in individuals with schizophrenia spectrum disorders, showing an overall prevalence of 56.4%, with great variation in the types of dysfunction. This underlines the urgency of no longer neglecting adverse sexual effects in the treatment of schizophrenia. In the same way that weight gain or somnolence are side-effects commonly considered in the evaluation of antipsychotic treatments, it is crucial to include sexual dysfunction in our benefit-risk analysis. Recognizing and addressing these adverse effects goes beyond improving patients' quality of life; it represents a significant step forward in establishing a solid therapeutic alliance. Open communication about these issues, which are often stigmatized or played down, fosters a relationship of trust between doctor and patient, which is essential for effective management of schizophrenia. By taking these undesirable effects into account, we are improving not only adherence to treatment, but also the overall management of the patient, by recognising the importance of sexual health as a fundamental component of the patient's well-being. 

This study therefore represents a significant advance, opening-up new prospects for treatments that are more respectful and tailored to patients' needs. 

What drives my research is the conviction that innovation in psychiatry is not limited to the discovery of new drugs. It also lies in our ability to rethink the way we treat patients, by integrating dimensions of their experience that have been underestimated until now. The aim is twofold: to improve the quality of life of people suffering from schizophrenia and to reduce the obstacles to effective treatment, particularly those associated with the side effects of medication. 

The implications of the studies I lead aim to have a direct impact on clinical practice by providing healthcare professionals with the tools they need to build a solid therapeutic alliance, thereby encouraging adherence to treatment and improving clinical outcomes. Considering sexual dysfunction, and more broadly the side effects of antipsychotics, is a concrete example of this influence. 

My vision is of a dynamic psychiatry that is constantly evolving, where care is tailored to the uniqueness of each individual, and where each scientific advance lights the way towards better mental health. 

I am therefore grateful to be able to share with you not only my research objectives, but also my vision of a future in which the management of schizophrenia is more enlightened, more effective and, above all, more humane. The road is long, the challenges many, but the passion that drives my quest is unshakeable. With determination and perseverance, we can provide meaningful answers to those struggling with mental suffering, and open up new horizons for the psychiatry of tomorrow. 

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