Early Warning Signs of Schizophrenia Often Missed

Pam Harrison

October 08, 2015

Early warning signs of schizophrenia are poorly understood by both patients and caregivers and are often missed, resulting in delayed diagnosis and treatment, results of a new survey show.

"We hear from families over and over again that although they noticed their child was not thinking clearly or was withdrawing from social situations, they did not realize that these behaviors can sometimes be symptoms of a serious mental illness," Paul Gionfriddo, president and CEO, Mental Health America, said in a statement.

"So many times these early warning signs are missed, particularly in early adulthood, when children are often away from home, and a lot of time can elapse before someone with schizophrenia gets the medical help they need."

Conducted online by Harris Poll on behalf of Alkermes, the Early Intervention in Schizophrenia survey included 600 participants who responded between June 2, 2015, and June 29, 2015.

Results showed that 61% of 300 caregivers of patients with schizophrenia indicated that not recognizing the early warning signs of schizophrenia was a barrier to seeking psychiatric help.

Perhaps not surprisingly, survey respondents also indicated that it took nearly 3 years, on average, for patients who would later be diagnosed with schizophrenia to see a psychiatrist, even after they had experienced early warning signs of the disease.

Psychiatrists estimated that more than half of patients with schizophrenia experience an acute psychotic episode prior to seeing a psychiatrist for the first time.

Among family caregivers of patients with schizophrenia, this percentage was much higher ― 85% reported that their family member with schizophrenia had experienced a psychotic episode before seeing a psychiatrist.

Almost three quarters of the psychiatrists surveyed indicated that it is common for people with early warning signs of schizophrenia to be diagnosed with another mental illness initially, most commonly, unspecified psychotic disorder, substance abuse, or bipolar disorder.

Furthermore, half of the psychiatrists surveyed indicated that psychiatrists are often hesitant to deliver the diagnosis of schizophrenia to young people and their families.

Virtually all of the psychiatrists surveyed also indicated that early warning signs of the illness are not acted on soon enough, but suggested that a frequent barrier to more intensive intervention is the family's reluctance to accept the diagnosis of schizophrenia.

The majority of both psychiatrists and caregivers believe the US healthcare system fails to provide adequate treatment for patients living with schizophrenia and that more can be done to provide more intensive treatment sooner to those who need it.

"The results of this survey clearly demonstrate a lack of awareness among caregivers about the early warning signs of schizophrenia and highlights some of the underlying barriers to care that prevent individuals from getting on the path to appropriate treatment sooner," Stephen Stahl, MD, PhD, adjunct professor of psychiatry, University of California, San Diego, School of Medicine, said in a statement.

"Because of the devastating consequences of schizophrenia, there is a compelling need to identify and diagnose this disease early so that patients can get the best care possible before significant disease progression."

Dr Stahl has served as an advisory board member for Alkermes.

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