We identified the population of schizophrenic patients under 65 in a geographically defined area. The number using psychiatric services based on a new District General Hospital unit in the course of one year was 364, a prevalence of 2.2 per 1000 adult population. Half the patients lived in supportive private households, most often with spouses or mothers. More women than men married and retained supporters. Patients and their primary supporters were interviewed separately. The PSE Catego programme classed 47 per cent of patients as psychotic. Supporters reported disturbed behavior in 65 per cent of patients, and restricted social performance in 78 per cent. There was evidence of hardship (emotional and physical ill-health, problems with children) in 90 per cent of households. Supporters' subjective distress was directly related to the presence of psychosis and disturbed behaviour and inversely related to the duration of the illness. Drop-out and failure to take medication appeared to be causes of the relatively high prevalence of psychosis.

Very early-onset schizophrenia (VEOS) is a rare disorder that is associated with poor outcomes, especially with securing aftercare plans that will lead to stabilization of illness and prevent recidivism. There is a scarcity of resources available to patients with VEOS and their families once they leave inpatient treatment to achieve long-term success. Here we report a case of a 12-year-old-female who was diagnosed with VEOS at age 11 and since that diagnosis has struggled with finding appropriate resources to meet her needs, requiring frequent hospitalizations and displaying a continued decline in functioning.