The Onset of Schizophrenia: Clinical and Evolutionary Characteristics

Abstract

Schizophrenia is one of the most severe psychiatric disorders. An early diagnosis and beginning of treatment may lead to a more favorable prognosis of the disease. We propose to study the clinical and evolutionary characteristics of the onset of schizophrenia. In this retrospective study, we reviewed the records of 61 patients who were hospitalized for schizophrenia in the department of Psychiatry 'A” in the University Hospital in Sfax (Tunisia), between August 2009 and January 2013. For each patient, we collected sociodemographic, clinical and evolutionary data. The average age of disease onset was 25.25 years. The majority of patients were males (78%) and single (85.2%). Paranoid schizophrenia was the most frequent type of schizophrenia (65.6%). The average duration of untreated psychosis was 2 years 11 months. The main pre-psychotic symptoms were: social isolation (48.6%), heteroaggressiveness (37.3%), irritability (34.2%), insomnia (32.3%), self-neglect (13.1%) and anxiety (4.9%). Patients were treated with oral typical antipsychotic drugs in 44.3% of cases, conventional depots in 39.3% and atypical antipsychotic drugs in 16.4%. After a hospital stay of 25 days on average, 47.5% of patients never came back. Patients followed-up at the outpatients unit had regular monitoring in 53.14% of cases and good adherence to treatment in 42.9%. Our study showed that more than half of patients were lost to follow-up or had poor adherence to treatment. Atypical antipsychotic prescription, having better neurological tolerance, and psychoeducation for the patient and his family, would be beneficial to improve the management of schizophrenia.