[Early recognition of schizophrenic psychoses. Family physicians in a key role]

Schizophrenic conditions occur primarily in young adulthood and, despite improved therapeutic options, still lead to persistent, more or less severe, social problems. Some 10% of these patients commit suicide. The recent years, evidence has been accumulating to suggest that the prognosis is all the more unfavorable, the longer psychotic symptoms go unrecognized and untreated. In Germany, at least one-quarter of these patients do not begin to receive treatment until more than a year after the appearance of "positive" symptoms (delusions, hallucinations). In comparison with England, for example, the German family doctor is less likely to be the first medical professional to see the patient with psychotic symptoms. In the investigated sample, however, the family doctor provided the quickest pathway to the psychiatric hospital. What is required is combined treatment with medications and psychotherapeutic measures flanked by a range of social aid groups and rehabilitation measures.