Schizophrenia


Schizophrenia
Criteria • Bizarre delusions
• Auditory hallucinations (in 75%)
• Blunted affect
• Loose associations
• Deficiency in reality testing, distorted perception; impaired functioning overall
• Disturbances in behavior and form and content of language and thought
• Changes in psychomotor behavior; loss of prosody
• Symptoms for longer than 6 months
Epidemiology Onset: male, ages 15 to 24; female, ages 25 to 34
Prevalence: 1 % of population cross-culturally
• More often in low social economic status
• 50% patients attempt suicide; 10% succeed
Neurochemistry • "Dopamine hypothesis of schizophrenia" suggests that symptoms arise because of a functional excess of dopamine activity in the CNS (mesolimbic/mesocortical pathways)
• Serotonin and glutamate may also play roles
Subtypes
Paranoid • Delusions of persecution or grandeur
• Often accompanied by hallucinations (voices)
Catatonic • Complete stupor or pronounced decrease in spontaneous movements
• Alternatively, can be excited and evidence extreme motor agitation
Disorganized • Incoherent, primitive, uninhibited
• Unorganized behaviors and speech
• Active, but aimless
• Pronounced thought disorder
Undifferentiated • Psychotic symptoms but does not fit paranoid, catatonic, or disorganized diagnoses
Residual • Previous episode, but no prominent psychotic symptoms at evaluation
• Some lingering negative symptoms

 

DDx
< 1 Month > 1 Month > 6 Months
Acute Stress
PTSD
 
Brief Psychotic Disorder
Schizophreniform
Schizophrenia