Intended for healthcare professionals


How to manage the first episode of schizophrenia

BMJ 2000; 321 doi: (Published 02 September 2000) Cite this as: BMJ 2000;321:522

Early diagnosis and treatment may prevent social disability later

  1. Sophia Frangou, senior lecturer in psychiatry (,
  2. Patrick Byrne, consultant in adolescent psychiatry
  1. Institute of Psychiatry, King's College London, London SE5 8AF
  2. South London and Maudsley NHS Trust, London SE5 8AZ

    The lifetime prevalence of schizophrenia is about 1%, but the associated social disability and cost are disproportionately large. According to the World Health Organization, schizophrenia is among the leading causes of disability worldwide. Representative measures have estimated the annual cost of schizophrenia in England to be £2.6bn and in Canada to be $C2.35bn (£1.06bn).13 A growing body of evidence suggests that the early stages of schizophrenia are critical in forming and predicting the course and outcome of the disorder.4 Accordingly, clinical and research interest is now focused on the early stages of the illness because early detection and treatment may result in a better prognosis and functional outcome.

    The first episode of schizophrenia typically occurs in the late teenage years or the early 20s.5 However, the illness can remain undetected for about 2–3 years …

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