Schizophrenia

Diagnostic Criteria

Characteristic symptoms: Two or more of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated): delusions hallucinations disorganized speech (i.e., frequent derailment or incoherence) grossly disorganized or catatonic behavior negative symptoms (i.e., affective flattening, alogia, or avolition)

time sinceSocial/occupational dysfunction: For a significant portion of the the onset of the disturbance, one or more major areas of
functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset.

When the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement.

Duration: Continuous signs of the disturbance persist for at least 6 months.

at least 1 month of symptoms (or less if successfully treated) and may include periods of residual symptoms. During these residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms (odd beliefs, unusual perceptual experiences).

Schizoaffective and Mood Disorder exclusion: Schizoaffective Disorder and Mood Disorder With Psychotic Features have
been ruled out because either:

No Major Depressive Episode, Manic Episode, or Mixed Episode have occurred concurrently with the active-phase symptoms If mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods.

Substance/general medical condition exclusion: The disturbance is not due to the direct physiological effects of a substance (a drug, a medication) or a general medical condition. Relationship to a Pervasive Developmental Disorder: If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).

History of Schizophrenia

The word schizophrenia is from Greek schizein meaning to split and phren meaning mind.

German Dr. Emile Kraepelin identified it as a specific disease in 1887.

documents Schizophrenia has beeninwith mankindmillennium B.C. as noted from early times in found in ancient Egypt the second connected with poison and describedThe Greeks and Romans Hearts, The symptoms are minutely in the Book of being demons. were
Paranoid Schizophrenia
Most common type of Schizophrenia aware of this disease but in those days anybody with abnormalities whether physical or mental were bracketed under one category.

A type of Schizophrenia in which the following criteria are met: Preoccupation with one or more delusions or frequent auditory hallucinations. None of the following are prominent: disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect. Your ability to think and function in daily life may be better than

with other types of schizophrenia.

concentration or not have as many problems with memory, You may dulled emotions.

Still, paranoid schizophrenia is a serious, lifelong condition that can lead to many complications, including suicidal behavior.

life. Delusions

paranoidWith effective treatment, you canleading a the symptoms of manage schizophrenia and work toward happier, healthier

You may believe that the government is monitoring every move you make or that a co-worker is poisoning your lunch.

Delusions of being singled out for harm

Delusions of grandeur the belief that you can fly, that you're famous or that you have a relationship with a famous person You hold on to these false beliefs despite evidence to the contrary.

Delusions can result in aggression or violence if you believe you must act in self-defense against those who want to harm you.

Auditory Hallucinations

Perception of sound, usually voices, that no one else hears.

The sounds may be a single voice or many voices. Voices may talk either to you or to each other. The voices are usually unpleasant.

They may make ongoing criticisms of what you're thinking or doing, or make cruel comments about your real or imagined faults.

Voices can also command you to do things that can be harmful to yourself or to others.

When you have paranoid schizophrenia, these voices seem real. You may talk to or shout at the voices.

Medication and Treatment Main treatment options: Psychotherapy Hospitalization Electroconvulsive therapy (ECT) Vocational skills training Medications:

First-generation (typical) antipsychotics control symptoms by affecting brain chemicals called neurotransmitters.

These have traditionally been very effective in managing delusions and hallucinations. They have frequent and potentially severe neurological side effects, including involuntary jerking movements. Typical antipsychotics, especially generic versions, are often cheaper than are their newer counterparts, which can be an important consideration when you need long-term treatment.

Second-generation (atypical) antipsychotics. These newer antipsychotic medications are effective at managing hallucinations, delusions and other symptoms, such as loss of motivation and lack of emotion.

These pose a risk of metabolic side effects, including weight gain, diabetes and high cholesterol. Other medications. It's common to have other mental health issues along with paranoid schizophrenia.

Antidepressants can be helpful if you have symptoms of

depression.

Anti-anxiety medications can be helpful if you have symptoms of

anxiety or agitation.

 Mood-stabilizing medications may help with aggression or

hostility.

Catatonic Schizophrenia

following: of Schizophrenia that is characterized by at least two of the A type

Motoric Immobility as evidenced by catalepsy (suspension of sensation, muscular rigidity, fixity of posture, and often loss of contact with environment) or stupor Excessive motor activity (that is apparently purposeless and not influenced by external stimuli) Extreme negativism (an apparently motiveless resistance to all instructions or maintenance of a rigid posture against attempts to be moved) or

Mutism Peculiarities of voluntary movement as evidenced by posturing (voluntary assumption of inappropriate or bizarre postures) Stereotyped movements, prominent mannerisms, or prominent grimacing Echolalia (uncontrollable and immediate repetition of words spoken by another person)

Echopraxia (abnormal repetition of the actions of another person) Medications and Treatment Main treatment options: Medications Electroconvulsive therapy (ECT) Hospitalization Psychotherapy Vocational skills training Medications:

Benzodiazepines. These medications, also called anti-anxiety medications, are sedatives. They are generally the medication of choice to treat catatonic schizophrenia.

Benzodiazepines, which may be injected in a vein, especially if you're in a state of catatonia, are typically fast acting, helping relieve catatonic symptoms quickly.

They may cause dependency with long-term use. These medications may also help if you have anxiety along with catatonic schizophrenia. You may need to take benzodiazepines for a period of days or weeks to relieve your catatonic symptoms.

Other medications. It's common to have other mental health issues along with catatonic schizophrenia. Antidepressants can be helpful if you have symptoms of depression. Mood-stabilizing medications may help with aggression or hostility. Antipsychotic medications. These are generally the medications of choice for schizophrenia.

They aren't used as often for the catatonic type of schizophrenia because they can actually worsen catatonic symptoms.