Schizophrenia Prognosis *Chronic 1/3 get better, 1/3 get worse, 1/3 stay the same 30% think about suicide & 10% attempt & die the symptoms go away with meds good prognosis factors= → acute onset → short prodromal phase → good premorbid f(x) → no structural brain abnormalities → no Fhx → good response to Tx → good support system Returning to work → stabilizing & reduction of symptoms → stress coping skills → workplace environment → flexibility → work hrs → part-time, remote work individual → supported employment programs placement & IPS employment centre support → supported model of employment for people with serious MI illness → continue at regular job of choosing → one on one assistance → integration with mental health services → focus on competitive employment → open labour market rather than sheltered or segregated work environments → ongoing assistance even after a job is secured → at least monthly → as long & as much as needed → no exclusion → job search based on preference → benefits planning → rather than Employment specialists judgement → Free of charge → at select mental health centers across the country → Disability employment services Financial Support → NDIS payments → Disability support pension → job seeking payments → concessions & healthcare cards Housing support services for people with mental illness → Housing + accommodation support initiatives → community rehab centres → doorway program → home & community care services → Mind Australia → temporary accommodation services e.g. link2home Marriage & for emergency accommodation → yes possible & support → understanding & supportive partner → set clear expectations → minimize conflict, strain in relationships → disclosure → benefits = → adherence to treatment ↓ stigma ↓ social isolation ↑ stability emotional + financial support support aims vital element in preventing relapse Pregnancy still can have healthy babies many antipsychotics have high safety data avoid switching in pregnancy as of fetal adverse effects from exposure to multiple drugs & relapse of the psychiatric disorder Few studies on long term side & effect on utero exposure to antipsychotics found no difference between exposed infants & controls antipsychotics have no affect on contraception effectiveness, but may ↑ clozapine blood concentrations combined oral vaginal ring progesterone only oral etonogestrel implant breastfeeding avoid breastfeeding when on clozapine as high risk of infant agranulocytosis as it goes in high concentrations in breast milk some have ADRs such as urinary retention & dystonic reactions if 1 parent -> 10-15% if 2 parents -> 35-46% if identical twin has -> 50% sis or bro have -> 10%