The Singapore Family Physician
Back to issue Vol 39 No. 1 - Schizophrenia
An Overview of Schizophrenia
The Singapore Family Physician Vol 39 No 1 - Schizophrenia
8 - 9
1 February 2013
Schizophrenia is characterised by multiplicity of symptoms affecting cognition, emotion and perception. The early age of onset, varying degree of intellectual and psychosocial impairment and possibility of long-term disability makes it a severe and devastating mental illness. Symptoms of schizophrenia are divided into four categories: positive, negative, disorganised and cognitive symptoms. various combinations of severity of these four categories are found in patients. They may also experience symptoms of other mental disorders, including depression, obsessive and compulsive symptoms, somatic concerns, and mood or anxiety symptoms. More than 80% of patients with schizophrenia have parents who do not have the disorder. The risk of having schizophrenia is greater in persons whose parents have the disorder. The peak incidence of schizophrenia is at 21 years. The onset is earlier for men (between ages 15 and 25 years) and later in women (between ages 25 and 35 years). Childhood onset schizophrenia is rare. The first psychotic episode is often preceded by a prodromal phrase lasting weeks or even years. The psychotic phase progresses through an acute phase, a recovery or stabilisation phase, and a stable phase. Early detection and treatment results in a better outcome. Management of schizophrenia is holistic and multidisciplinary. Family physicians play an important role in the early detection of those who are psychotic; managing patients who are stabilised and require maintenance pharmacotherapy; and the detection of physical illnesses of cardiovascular diseases, obesity and diabetes which have a higher prevalence among patients with schizophrenia as compared to the general population.