When friends and family first notice signs of psychosis in a loved one, it can be very frightening.

Because schizophrenia often evolves in young adults anywhere from the age of 16-26, these early symptoms could mimic the behaviors related to drug and alcohol abuse or adolescent turmoil such as rapid changes in school performance or relationships with friends.

One of the key factors in successfully treating schizophrenia is early intervention, which is the focus of treatment at Barnes-Jewish Hospital and Washington University. Treating patients with schizophrenia has been a life-long mission and learning experience for John Csernansky, MD, Barnes-Jewish Hospital psychiatrist, Gregory B. Couch Professor of Psychiatry at Washington University School of Medicine and Director of the NIH-funded Conte Center for Neuroscience of Mental Disorders.

One of the greatest pressures for families during this time is recognizing the symptoms and knowing where to turn. Dr. Csernansky understands there are often time restraints that make it difficult for private practice physicians to truly determine if a patient is in the early stages of a psychotic disorder. Physicians in the psychiatry department at Washington University and Barnes-Jewish have developed a program that helps them sift though symptoms to make a good clinical diagnosis and select the best treatment by minimizing the use of multiple, unnecessary drugs and drug doses that are too high or too low.

"Over the last decade we have learned to treat the illness more aggressively from the onset," says Dr. Csernansky. "It used to be thought that the course of schizophrenia couldn''t be altered with treatment but that has clearly changed."

A number of studies have shown, thanks in part to the second generation of anti-psychotic drugs and proper drug treatment, many people with schizophrenia have gone into remission, returned to school, work and a productive life, he adds.

In addition because of research support, Dr. Csernansky says he and his colleagues have the opportunity to spend an extended amount of time with both the patient and family which is vital to their diagnosis.

"If we can get people engaged in treatment early we increase the chance of a successful outcome," he says.