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Feature Article

Management of schizophrenia

Nicholas Keks, Judy Hope, Rajan Thomas

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Abstract

Some patients with schizophrenia are misdiagnosed as suffering from anxiety and depression and treated inappropriately with antidepressant medication (which can exacerbate psychosis) and psychotherapy. It is important to recognise early psychosis because a delay in treatment can impair long-term outcome.

Key Points

  • Treatment advances allow most people with schizophrenia to live and function in the community.
  • Most GPs see about four to five such patients, as schizophrenia and related psychoses affect up to 5% of the population.
  • Antipsychotic medication is the cornerstone of treatment, which is needed lifelong for most patients with established schizophrenia.
  • Many patients with schizophrenia require intensive psychosocial interventions, including case management, vocational rehabilitation and housing, so GPs need to work collaboratively with specialist services.
  • GPs are in an ideal situation for early detection of prodromal psychosis. They can also monitor mental and physical state of the patient, side effects and/or adherence to medication, and provide physical care.

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