Hustig H H, Norrie P D
Extended Care Services, Royal Adelaide Hospital, SA.
Med J Aust. 1998 Feb 16;168(4):186-71.
There is an increasing expectation that general practitioners will be more involved in treating people with schizophrenia. Newer drugs are associated with better clinical outcomes, especially in relation to negative symptoms (ie, apathy, under activity, slowness, social withdrawal). Some patients make a full recovery or are quite functional between episodes. Identifying early warning signs will lead to reduction of disability. Side effects of medication must be treated vigorously and expediently to enhance compliance. Secondary symptoms of dysphoria and depression must be treated to prevent suicide. Issues of alcoholism and substance abuse must be addressed, providing education on their implications for the course of the illness. People with schizophrenia need continuity of care, which the general practitioner may be best placed to provide because of a long-term commitment to the patient. Involvement with the family (education, support and a collaborative approach in monitoring and supporting the patient's well-being) is vital.
人们越来越期望全科医生更多地参与到精神分裂症患者的治疗中。新型药物与更好的临床结果相关，尤其是在阴性症状（即冷漠、活动不足、迟缓、社交退缩）方面。一些患者能完全康复，或在发作间期功能相当正常。识别早期预警信号将减少残疾。必须积极且迅速地治疗药物副作用以提高依从性。必须治疗烦躁不安和抑郁等继发症状以预防自杀。必须解决酗酒和药物滥用问题，提供关于它们对病程影响的教育。精神分裂症患者需要持续的护理，由于全科医生对患者的长期关注，可能最适合提供这种护理。让家庭参与（教育、支持以及在监测和支持患者福祉方面采取协作方法）至关重要。
