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SCHIZOPHRENIA AND THE INDIVIDUAL

There is no one description of schizophrenia which fits all people. For some the illness starts suddenly: the (usually) young person with little warning becomes acutely ill and shows signs of thought disorder and other psychotic symptoms. In others the onset is slower, more insidious, and the individual may show signs of withdrawal, self-neglect or pre-occupation with odd ideas before more obviously bizarre behaviour occurs.

Although some people have one brief psychotic episode, recover, and are not ill again, this may not be diagnosed as schizophrenia. Thus, by definition, schizophrenia becomes an illness in which relapses and chronic symptoms are expected. Even so, some people with the illness do well often being maintained on medication, and are able to to live ordinary or near ordinary lives. Others find the chronic symptoms of apathy, lack of motivation, poor concentration, loss of confidence and withdrawal make working impossible, social life difficult and may lead to 'day-night reversal' in their living pattern. A minority of people have the more florid symptoms usually associated with the acute phase most of the time and show little response to medication.

For almost everyone acute schizophrenia means spending some time in hospital as an in-patient. Increasingly patients are being discharged more quickly than in the past and continued care of these people is based in the community. In most areas of Britain the level of community care is not sufficient to meet the demand.

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