NURS 6670 The PMHNP is preparing a presentation for a primary care conference

The PMHNP is preparing a presentation for a primary care conference


Schizophrenia is a condition with a wide range of possible symptom presentations that may be more subtle than clinical manifestations seen in other psychiatric conditions, making it challenging for primary care providers to recognize and make a prompt accurate diagnosis.

A primary care practitioner comes face-to-face with this mental disorder at least once in a career. Although the incidence of schizophrenia is 1% worldwide, and 3% in the United States, it can be very difficult to diagnose (National Institute of Mental Health, 1999). In fact, the earliest symptoms are subtle and easily overlooked: Absentmindedness, difficulty concentrating on an ordinary task, social withdrawal, irritability, nervous habits such as nail biting or twirling one’s hair, excessive innocence, difficulty responding to criticism.

Early recognition and referral to treatment can help patients with schizophrenia live full and productive lives in their communities. Here are some common signs to watch for when caring for patients:

A diagnosis of schizophrenia should be considered in patients who have symptoms of both psychosis and depression. In the course of a primary care evaluation, consider asking a patient if they experience auditory or visual hallucinations, or delusions of being watched.

It is important to remember that, because of the nonspecific nature of many of the early signs and symptoms of schizophrenia, if you see any one or more of the following signs in a person for the first time in close relationships, work relationships or new situations, or receive complaints from family members about these behaviors, it could be an important clue to the existence of this disorder.

Schizophrenia is characterized by abnormal social behavior and cognition, and may also be accompanied by abnormal motor behavior. Common signs and symptoms include hallucinations, delusions, disorganized thinking, incoherent speech and behavior, flattened affect and emotional withdrawal.

The sooner schizophrenia is diagnosed, the sooner it can be treated. Schizophrenia typically manifests in adolescence or early adulthood. Many patients suffer years of unrecognized symptoms before they are correctly diagnosed.

All forms of schizophrenia occur more frequently in males than in females. Only 15 percent to 25 percent of people with schizophrenia are diagnosed before the age of 35, even though schizophrenia can be detected in high school or college.

The primary presenting symptoms of schizophrenia often include psychotic symptoms, such as delusions and hallucinations.

Most people with schizophrenia have symptoms that first appear in early adulthood. Delusions, hallucinations, and thought disorders are the most common early symptoms of schizophrenia. Some people have only a few of these symptoms or only one symptom. Some do not believe that they are ill and do not seek help.

Common signs of schizophrenia include increased energy, restlessness, and a lack of motivation.


The PMHNP is preparing a presentation for a primary care conference. The topic is “Recognizing Schizophrenia: Common Signs and Symptoms Encountered by the Primary Care Provider.” A critical point to stress to primary care clinicians is that:

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