On the front line: Survey on shared responsibility. General practitioners and schizophrenia

Context: General practitioners (GP) play a preponderant role in the treatment of patients suffering of schizophrenia. Objectives: Discovering the number of patients with schizophrenia who are treated by GPs; the needs and attitudes of GPs, their knowledge concerning diagnosis, and the treatment they provide. Methodology: A postal survey was conducted with Quebec GPs who were randomly chosen. Results: A total of 1 003 GPs have participated in the survey. Among them, a small percentage have to treat an early onset schizophrenia and the GPs have expressed their wish to be more informed on the accessibility of specialized services. Results pertaining to questions on diagnoses and knowledge on treatments are inconsistent. The majority of GPs treat the first psychotic episodes with antipsychotic medication. Only a third of GPs surveyed propose maintaining the treatment after a first psychotic episode, in accordance with international recommen dations and the recent Canadian guidelines on practices that recom mends at least 6 to 12 months of treatment after a partial or complete clinical response. Time given by male GPs to a first contact varies between 10 and 20 minutes, while 80 % of female GPs spend at least 20 minutes. The adverse effects of antipsychotic medication that raise most concern is weight gain before neurological signs. Conclusion: some of this survey's data should be considered by various professional and governmental associations, in order to improve the place of GPs in a health plan destined to treat schizophrenia.