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Feature Article

Schizophrenia: the GP’s crucial management role

Judy Hope, Nicholas Keks

Figures

© katarzyna bialasiewicz/ istockphoto.com model used for illustrative purposes only
© katarzyna bialasiewicz/ istockphoto.com model used for illustrative purposes only

Abstract

Schizophrenia and related psychoses are conservatively estimated to affect more than 100,000 Australians, as well as their families, friends and colleagues. People with schizophrenia are more likely to experience health morbidity and to die prematurely, by up to 25 years, from suicide or physical illness. GPs are in an ideal position to detect and treat schizophrenia and related psychoses and to monitor and manage the physical health of patients with psychotic illnesses.

 

Key Points

  • Early recognition and referral are key in managing schizophrenia and related psychoses.
  • Management should occur within a framework of autonomy and self-determination and, where possible, with family or carer inclusion.
  • Pharmacological and psychosocial treatments improve outcomes, including quality of life, for people affected by schizophrenia.
  • Antipsychotic, mood stabiliser and antidepressant medications may all be indicated in treating psychoses.
  • Several new atypical and depot antipsychotic medications (oral brexpiprazole and depot aripiprazole and paliperidone) are available on the PBS.
  • When risk is high or escalating, safety is paramount and urgent referral should be considered.
  • Monitoring and managing the long-term physical health of people with schizophrenia is crucial to reducing morbidity and mortality.
  • GPs have a key role in recognising substance misuse and supporting behavioural change.

Figures

© katarzyna bialasiewicz/ istockphoto.com model used for illustrative purposes only
© katarzyna bialasiewicz/ istockphoto.com model used for illustrative purposes only