EARLY SCHIZOPHRENIA

The recent increase of interest in therapy is opening up a new chapter in the attack upon schizophrenia. Whatever may be the eventual evaluation of the more recently introduced therapeutic procedures, they have served to focus our attention upon the fact, long recognized in general medicine, that the results to be obtained from any therapy are dependent not merely upon the nature of that therapy but also upon the recency of the illness. Through having our attention so focused we are forced to appreciate the fact that very early schizophrenia still constitutes a relatively unexplored territory. Entry into this territory calls for new ideas on the social problems involved in bringing the early schizophrenic promptly under treatment, or where the treatment should be carried out and in what it should consist.

These fresh steps can, however, be taken only in the light of more extensive acquaintance with the data, both personal and environmental, presented by the early schizophrenic. Hence this survey in which we have attempted to find out what are the earliest things which the relatives, friends, and others in contact with the subsequent patient notice going wrong with him. We have tried to see in what environment the patient is during these early stages and how the various people around him during this time— his relatives and friends, his employer and his physician—react to his growing abnormality. Finally we have considered the development of certain social trends—the growing acceptance of routine health examinations and the increasing utilization of general hospitals for psychiatric treatment—which may be of immense importance in the satisfactory detection and treatment of early schizophrenia.