Reviewed byAndrey Vetrov, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F20
- Who provides care
- a psychiatrist, and when needed a clinical psychologist (neuropsychological assessment) and a psychotherapist for work with the family
- Format
- in-person appointments at our clinics in Almaty and Astana, psychiatrist home visits, online check-ins between visits; inpatient care during an acute relapse
- Duration
- first appointment 60–90 minutes; finding the right therapy takes weeks to months; maintenance treatment usually lasts for years
- Confidentiality
- medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System,” anonymous care, no entry in the state psychoneurological dispensary (PND) registry
- When it is urgent
- threats to self or others, refusal of food and water, completely disorganized behavior, voices commanding the person to cause harm — call 103 or 112 immediately
- Outcome
- fewer positive (psychotic) symptoms, fewer relapses and hospital stays, a return to work, study and ordinary family life
What to know
When a family first hears the word “schizophrenia,” the most common reaction is fear and a sense that it is a life sentence. I always start the conversation somewhere else: this is a chronic illness that can be treated, much like high blood pressure or diabetes — consistently, calmly and according to a plan. With regular treatment, many patients have episodes only rarely; they work, study and live with their families. The doctor’s job is not to “cure it in one course,” but to find a stable state together with the patient and keep it for years.
Schizophrenia is never diagnosed after a single conversation, and certainly not from a relative’s description over the phone. The psychiatrist looks at how long the symptoms have lasted (under ICD criteria, at least one month of clear symptoms) and rules out physical (organic) causes, the effects of substances, severe depression and bipolar disorder. That is why the first stage is an unhurried assessment: a clinical interview, a detailed history and, when needed, blood tests, an EEG, an MRI and a neuropsychological (pathopsychological) assessment with a clinical psychologist.
When to have a loved one seen by a psychiatrist
- the person hears voices or sees things that others around them do not notice
- unusual beliefs have appeared: being watched, a “special meaning” behind events, other people’s thoughts in their head
- speech has become fragmented, and it is hard to follow how one sentence connects to the next
- interests are gradually fading, and the person stops taking care of themselves and socializing
- performance at school or work has dropped sharply for no obvious external reason
- suspicion toward family members, curtains kept closed, refusing food “because it is dangerous”
- emotions have become flat or do not fit the situation, and sleep is disrupted
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
What causes schizophrenia and what triggers relapses
There is no single cause. Current guidelines (WHO, APA, NICE) describe schizophrenia as the result of a combination of inherited vulnerability, features of brain development and external stress. Having a relative with the illness raises the risk, but it does not mean the illness will necessarily develop. It is also important to understand something else: schizophrenia is not caused by “bad parenting,” and parents do not need to look for guilt in themselves — that gets in the way of treatment far more than it helps.
Relapses are most often triggered by quite specific things: stopping medication on one’s own, drinking alcohol and especially using psychoactive substances, chronic lack of sleep, severe stress, moving house and family conflicts. That is why my treatment plan always includes not only medication but also a review of the patient’s personal “triggers”: what happened before the last episode, what early warning signs the family noticed, and what to do if those signs appear again.
How schizophrenia treatment works at Akalam: step by step
The first step can be taken online: relatives tell the doctor the history, send discharge summaries and a list of current medications, and together we decide where the assessment is best done — at the clinic or at home. Next comes the in-person appointment: a conversation with the patient, a separate conversation with the family and a plan of tests. Once the diagnosis is confirmed, we choose therapy; during the first weeks we are in frequent contact to assess the effect and any side effects, and then we move to scheduled visits every 1–3 months.
A first diagnosis cannot be made online, and antipsychotic treatment cannot be started without an in-person assessment. Outpatient care is not appropriate if the patient is a danger to themselves or others, refuses food and drink, or is completely disoriented. In such cases inpatient care is needed, and if there is a direct threat to life, call 103 or 112. Involuntary hospitalization is possible only under the procedure established by the law of the Republic of Kazakhstan, by court decision.
How we help
Medication
The foundation of treatment is antipsychotic medication (neuroleptics), selected only by a psychiatrist based on the symptoms, age, other health conditions and past experience with treatment. Antidepressants or mood stabilizers are sometimes added. I explain to the patient which side effects are possible and what to do about them, because fear of side effects is the main reason people stop treatment. If taking a pill every day is difficult, we discuss long-acting injectable forms.
Psychoeducation for the patient and family
These are calm sessions in which we go over what the illness is, how the medications work, how to recognize early signs of a relapse and what to do at that moment. NICE guidelines explicitly list family intervention as an essential part of treatment, because it reduces how often relapses happen. The family learns to talk with their loved one without arguing about delusions and without pressure.
Psychotherapy and cognitive training
CBT for psychosis (CBTp) helps a person relate differently to voices and distressing thoughts, reduce fear and cope better with residual symptoms. Cognitive training supports attention, memory and planning, which are often affected in schizophrenia. Psychotherapy does not replace medication; it works alongside it and is added once the acute phase is over.
Social recovery
After stabilization, we discuss returning to study or work — gradually, without overload. We help build a routine of sleep, activity and rest, and support the person in giving up alcohol and substances that provoke relapses. The goal is not just for the person to “be calm,” but to live their own life: to socialize, work and make plans, with the doctor remaining close by as support.
How treatment works
- 01Call or WhatsAppThe administrator and the doctor on duty clarify the situation and tell you what to do right now.
- 02Examination or consultationThe doctor visits your home, sees you at the clinic or joins by video.
- 03Treatment planWe choose the format — at home, inpatient, psychotherapy or rehab — with a clear price.
- 04Ongoing supportYour doctor and psychotherapist stay in touch: follow-ups, family support and relapse prevention.
Myths and facts
MythSchizophrenia means a split personality
FactThese are different conditions. A “split personality” (dissociative identity disorder) is a separate diagnosis. In schizophrenia, the personality does not divide in two; instead, perception, thinking and emotions are disrupted: voices and delusional ideas appear, and activity levels decline.
MythPeople with schizophrenia are dangerous
FactMost people with this diagnosis never show aggression and are more likely to become victims of violence themselves. The risk increases without treatment and with alcohol or drug use, which is why regular therapy is the best protection for both the patient and the family.
MythMedication turns a person into a “vegetable”
FactModern treatment is selected to relieve symptoms while keeping thinking clear. If drowsiness or stiffness appears, that is a reason to tell your doctor and adjust the treatment — not to stop the medication on your own.
Prices: Schizophrenia treatment
| Schizophrenia treatment | 25 000 ₸ |
| Psychiatrist consultation at the clinic | 15 990 ₸ |
| Psychiatrist home visit | 35 000 ₸ |
| Follow-up visit, treatment adjustment | 12 000 ₸ |
| Phone consultation | free |
Prices are approximate: the doctor confirms the exact cost after the examination, before treatment starts.
Confidential
We do not register patients with state dispensaries or share information with employers. You do not have to give your surname; doctors arrive in unmarked cars. Medical confidentiality is protected by the Code of Kazakhstan “On Public Health and the Healthcare System”.
Clinic addresses
FAQ
Can schizophrenia be cured completely?
To be honest, in most cases we are talking about long-term remission rather than a one-time cure. In some patients the illness does not return for years after a single episode; others have repeat episodes. With regular treatment and follow-up, many people live full lives: they work and start families. The outlook is better when treatment begins early.
What should we do if our loved one refuses to see a psychiatrist?
An adult cannot be treated without consent, except in cases provided for by the law of the Republic of Kazakhstan — by court decision. Start with a consultation for the family: the doctor will suggest how to talk without arguing about the symptoms, focusing on what bothers the person themselves — insomnia, anxiety, fatigue. People often agree to an assessment at home more easily than to a clinic visit.
How many years will medication be needed?
After a first episode, international guidelines recommend maintenance therapy for at least one to two years; after repeat episodes — longer, sometimes indefinitely. Only a psychiatrist decides whether to reduce the dose, and it is done gradually and under supervision. Stopping abruptly on one’s own is one of the most common causes of a new relapse.
Will I be put on a registry?
When you come to Akalam on a paid, anonymous basis, you are not placed on the state dispensary registry. Information about your treatment is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System” and is disclosed only in cases expressly provided for by law. You do not have to give your real name at the first appointment.
Can I be treated online if I don’t live in Almaty or Astana?
The first assessment must be in person — a psychiatrist will come to your home, or you can come to the clinic. After that, much of the follow-up can be done by video: checking how you feel, reviewing side effects and adjusting the plan. Lab tests can be done at any laboratory where you live, and the doctor reviews the results remotely.
Is schizophrenia passed on to children?
There is an inherited predisposition, and the risk for a patient’s children is higher than average, but in most cases the children stay healthy. The illness is determined by a combination of many factors, not by a single gene. If you are planning a pregnancy, discuss your treatment with your psychiatrist in advance: some medications need to be adjusted.
Sources and review
Prepared by the Akalam medical editorial team based on:
- ICD-10 and ICD-11: mental and behavioural disorders
- Clinical protocols of the Ministry of Health of Kazakhstan
- Code of Kazakhstan “On Public Health and the Healthcare System”
- WHO: mental health and substance use
- NICE and APA clinical guidelines
This information is for reference and does not replace a doctor's consultation. Editorial policy