Summary

• An illness characterised by psychosis, disorganised speech, negative symptoms, or stereotypical behaviour occurring for a period of at least 1 month and associated with at least a 6-month period of functional decline.
• Characteristic factors are positive symptoms (auditory hallucinations, thought disorder, and delusions) and negative symptoms (demotivation, self-neglect, and reduced emotion).
• Onset is usually in early adulthood and may be preceded by years of ill-differentiated symptoms, from behavioural changes and delusions to frank psychosis.
• Initially, patients are usually referred by family members. As the illness progresses, patients tend to self-refer or are brought in by a case manager or law enforcement officer.
• Antipsychotic therapy and psychosocial interventions are effective for most patients, but to varying degrees.
• Suicidal tendency is one of the most dangerous complications. As many as 15% of patients may kill themselves. The risk is highest at the onset of the illness.