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SCHIZOPHRENIA
Clinical syndrome w/ profoundly disruptive
psychopathology that involves cognition,
emotion, perception & behavior
Begins before age 25, persist throughout
their life & affects persons of all classes
AFFLICTS ABOUT 1% OF THE
POPULATION USUALLY
BEGINS
BEFORE AGE 25
ONSET:
Before 10 or after 60 extremely rare
OUTCOME
- Better for female than male
- Men likely impaired by negative symptoms
LATE ONSET SCHIZOPHRENIA
Onsets occurs after age 45
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PSYCHIATRY II
C) Duration: persist at least 6 mons
D) No due to a substance/general medical
condition
SUBTYPES:
1. PARANOID:
preoccupation of with one or more delusions,
frequent auditory hallucinations
2. DISORGANIZED:
disorganized speech & behavior, flat or
inappropriate affect
3. CATATONIC:
motoric inability, waxy flexibility, excessive
purposeless motor activity, extreme
negativism, peculiar voluntary movements,
echolalia, echopraxia
4. UNDIFFRENTIATED TYPE:
criteria A is present but the criteria are not
met for paranoid, catatonic & disorganized
5. RESIDUAL TYPE
absence of prominent symptoms but has
continuing evidence of negative symptoms
(odd beliefs, unusual perceptual experiences)
OTHER SUBTYPES:
Bouffee Delirante (acute delusional psychosis)
Oneiroid
Paraphrenia
Simple Deteriorative Disorder
Early Onset Schizophrenia
Deficit Schizophrenia
CLINICAL SYMPTOMS
No clinical symptoms is pathognomonic
History is essential for diagnosis
Symptoms changes with time
Premorbid signs & symptoms:
- quiet, passive, introverted, few
friends no dates or close friends,
avoid team sports, enjoy solitary
activities avoids social activities
POSTIVE SYMPTOMS: (productive)
Hallucinations & Delusions
NEGATIVE SYMPTOMS: (deficit)
Affective flattening or blunting, poverty of
speech (alogia), lack of motivation, social
withdrawal
MENTAL STATUS EXAMINATION:
Appearance disheveled, agitated, silent,
immobile
MOOD, FEELING & AFFECT - reduced emotional
responsiveness
PERCEPTUAL DISTURBANCES auditory
hallucination
COURSE & PROGNOSIS
Course: has exacerbation & remission with
deterioration of functioning following relapse
Prognosis:
Criteria for good prognosis late onset,
acute onset, married, good support system,
positive symptom, good pre-morbid social, sexual
& work histories
DIFFERENTIAL DIAGNOSIS
Secondary Psychotic Disorder
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