title: Prodromal schizophrenia in primary care: a randomised sensitisation study.
abstract: BACKGROUND
  GPs are often the first point of contact for patients with prodromal schizophrenia. Early intervention, and therefore early detection, of schizophrenia is pivotal for the further disease course. However, recent studies have revealed that, due to its low prevalence in general practice and its insidious features, prodromal schizophrenia often remains unnoticed.
  
  
  OBJECTIVE
  To test whether a repeated sensitisation method using clinical vignettes can improve diagnostic knowledge of GPs.
  
  
  METHODS
  Postal survey using anonymous questionnaires. Repeated sensitisation model using clinical vignettes.
  
  
  METHODS
  GPs in three distinct regions in Switzerland covering a general population of 1.43 million.
  
  
  METHODS
  The study was conducted between September 2008 and October 2009. Questionnaires were sent to 1138 GPs at baseline, and at 6 and 12 months. After randomisation, 591 GPs were sensitised at 1, 3, and 5 months, while no sensitisation was carried out in the remaining 547 GPs.
  
  
  RESULTS
  The overall response rate was 66% (750 GPs). Sensitised GPs demonstrated a highly significant increase in diagnostic knowledge at 6 and at 12 months when compared to their own baseline knowledge scores and also to non-sensitised GPs (P<0.001). In particular, awareness of insidious features, such as functional decline and social withdrawal as signs of prodromal schizophrenia, accounted for this effect.
  
  
  CONCLUSIONS
  Theoretical knowledge of prodromal schizophrenia among GPs can successfully be increased by repeated sensitisation models using clinical vignettes.
authors.affiliation: University Hospital of Psychiatry, University of Bern. andor.simon@bluewin.ch
authors.forename: Andor E
authors.initials: AE
authors.lastname: Simon
authors.forename: Sabrina
authors.initials: S
authors.lastname: Jegerlehner
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller
authors.forename: Katja
authors.initials: K
authors.lastname: Cattapan-Ludewig
authors.forename: Peter
authors.initials: P
authors.lastname: Frey
authors.forename: Marcus
authors.initials: M
authors.lastname: Grossenbacher
authors.forename: Erich
authors.initials: E
authors.lastname: Seifritz
authors.forename: Daniel
authors.initials: D
authors.lastname: Umbricht
mesh_terms: D000704:Analysis of Variance; D002983:Clinical Competence / Q000592:standards; D042241:Early Diagnosis; D058006:General Practice; D006801:Humans; D011379:Prognosis; D012559:Schizophrenia / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D013557:Switzerland