The Northwick Park Study of first episodes of schizophrenia. I. Presentation of the illness and problems relating to admission.

Patients referred over 28 months from nine medical centres for a trial of prophylactic neuroleptic medication following first episodes of schizophrenic illness (462) were assessed with the Present State Examination, WHO scales for disability, past history, and sociodemographic factors, and a rating of disturbed behaviour; 253 fulfilled the study criteria; of the 209 who did not, 54 did not meet the diagnostic criteria, 65 had a history of a previous episode, and in 15 the psychotic illness was found to have an organic basis. The interval between onset of illness and admission varied widely, but was often more than one year and associated with severe behavioural disturbance and family difficulty e.g. in arranging appropriate care. Current arrangements for initiating management of first schizophrenic illnesses are frequently unsatisfactory.