Sometimes, the first physician a patient with psychiatric problems sees is a family doctor. These general practitioners may not witness the first psychotic episode a patient experiences, but they see people with subtle psychological changes that may precede psychosis. These doctors should be aware of the basic warning signs and symptoms of schizophrenia and other psychiatric disorders. They should know how to conduct a preliminary psychiatric exam and, if appropriate, immediately refer the patient to a psychiatrist or other mental health care specialist who can perform a thorough exam and start a treatment program.

You should find a psychiatrist who specializes in, or has a lot of experience treating, patients with schizophrenia. Treating a person with this complex condition requires individualized attention. The psychiatrist should have up-to-date knowledge about the best possible medications to try, correct dosages, and approaches for monitoring the benefits and possible side effects of the medication. Additionally, the psychiatrist must provide you with referrals for other treatment resources such as psychotherapy, vocational therapy, and other therapies, so you receive comprehensive care and maximize the benefits and outcome of your treatment.

Avoiding Missed Diagnoses

Symptoms should not be brushed aside as “typical teenage problems” or “a bit of depression.” A good family doctor will be suspicious of the psychological deterioration or cognitive decline of a patient and should direct you toward specialized help as soon as possible. Early detection allows early intervention and can prevent some very destructive consequences, some of which may be irreparable.

Schizophrenia is sometimes misdiagnosed as depression, especially in cases of young people in the early stages of schizophrenia. Unfortunately, the patient will suffer from the delay. It is crucial that a proper psychiatric examination be performed for individuals showing early signs of schizophrenia. Some patients may be too embarrassed to tell the doctor about the strange experiences and thoughts they are having, and input from the patient's family can help the psychiatrist reach the correct diagnosis sooner and more accurately.

It is also possible that a patient may not be totally forthcoming with the doctor if she is paranoid or afraid of being “put away.” Sharing observations by other family members is almost always an essential part of making the right diagnosis. If a doctor does not make time to meet with the family, find another doctor. A doctor should talk to family members to acquire more information about the patient's condition and answer the family's questions about how they can help in the management of this disease. This should be the minimum standard for treating schizophrenia. If any doctor dismisses serious, persistent, negative changes you observe in the personality or behavior of a young adult or adolescent, find another doctor.

Physicians may err by not working closely enough with a patient. Make sure your doctor does the following:

• Ensures that the person is continuing to get her recommended treatment

• Accommodates the person by adjusting doses or changing medications in response to her concerns

• Gives the person clear instructions in a straightforward treatment plan

The Comfort Factor

It is important that you and your loved one feel comfortable with the doctor. Many patients stop treatment because they do not like their doctors. Rapport between doctor and patient may not be immediate. One session is not enough to determine if you have found a compatible physician, but if after several sessions or weeks the patient feels no trust or willingness to confide in one doctor, look for another.