Background: Schizophrenia is a major mental disorder which has to be assessed early and managed actively even though long term functional outcome remains relatively poor. The aim of the study is to analyze negative symptoms, suicidal risk and substance use in first episode schizophrenics in comparison with multi-episode schizophrenics.Methods: 30 patients with drug naive first episode schizophrenia and 30 patients with multi episode schizophrenia, who attended the outpatient department of Psychiatry, Government Stanley Medical College, Chennai, Tamilnadu, India were studied to compare predisposing factors and spectrum of symptoms for Schizophrenia for a period of one year (January 2010-December 2010). Psychiatric questionnaire by Michael C. Hilton, DAST by Harvey A. Skinner, AUDIT by WHO, Suicide risk scale by National Health and Medical Research Council, PANSS by SR Kay were used to assess patients.Results: Unemployment and family history of suicide attempts were observed more in drug naive first episode schizophrenics. 90% of these patients had completed their primary education while 47% of multi-episode schizophrenics were illiterates. Positive symptoms (delusions, hallucinatory behaviour and suspiciousness) and negative symptoms (blunted affect, emotional withdrawal and social withdrawal) were observed more in first episode schizophrenics while PANSS, DAST, AUDIT scores did not find any differences between both the groups.Conclusions: In our study, the first episode schizophrenia patients were more educated, more unemployed and had more family history of suicide, elevated sub score of positive symptoms as measured by PANSS. Relative assessment of violence and serious behavior problems that are related to positive symptoms must be done and managed with anti psychotics.

Background: The chronic nature of Schizophrenia has a devastating impact not only on the patients but also in their caregivers. The burden experienced by the caregivers can seriously affect the psychological wellbeing and caregivers take up multiple coping strategies to tackle the burden. This study was undertaken to find the association between symptom profile of Schizophrenia patients and the perceived wellbeing of their caregivers.Methods: 30 patients with schizophrenia and their caregivers (parents or spouses), who were actively involved in care of the patient for at least 6 months prior to assessment, were included in the study. Patients were evaluated by socio demographic data sheet and Positive and negative syndrome scale (PANSS) while their caregivers were evaluated using Caregiver socio demographic data sheet, Burden Assessment Schedule (BAS), Coping Checklist (CCL) and Psychological Well Being Questionnaire (PWBQ). Statistical analysis was done using Chi square test and Fischer exact test for categorical variables, Pearson correlation to find correlation between data and Analysis of variance (ANOVA) to find significance of study parameters between groups. p < 0.05 was considered significant.Results: Burden experienced by caregivers was more with a severe symptom profile. Moderate correlation is found between patient’s positive symptom profile, negative symptom profile and burden. There was a weak correlation between patient`s symptom profile and care givers coping strategies. The total PANSS scores did not influence the pattern of coping. There was no statistically significant difference in coping strategies in positive and negative symptom of schizophrenia. There was a moderate negative correlation between patient`s symptom profile (positive and total PANSS score) and psychological wellbeing in caregivers. However, there was a weak correlation between patient negative symptom profile and psychological wellbeing in caregivers.Conclusions: Burden and wellbeing of the care givers of schizophrenic patients are closely inter related. These parameters are in turn related to patient’s symptoms profile namely, the overall psychopathology and more with the positive symptoms of schizophrenia. Though all care givers used different coping strategies, there did not appear to be any interrelation between strategies and the perceived burden, well-being and patient’s psychopathology.