Avolition—apathy—particularly common in those who have had schizophrenia for years
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Avolition—apathy—particularly common in those who have had schizophrenia for years. Anhedonia—lack of interest in recreational activities ; inability to experience pleasure Social withdrawal Catatonia—may grimace, adopt strange facial expressions or bodily positions. Catatonia—may grimace, adopt strange facial expressions or bodily positions. May exhibit increase in activity or catatonic immobility Unusual postures are adopted and maintained for long periods. Waxy flexibility. Delusions of persecution and grandeur are common Delusions of persecution and grandeur are common Ideas of reference—unimportant or trivial events have personal significant The “paranoid constitution” gives some sense of purpose and integrity Prognosis generally better (in the west) More common style in the west—less common in less developed countries Diffuse symptoms Diffuse symptoms Hallucinations and delusions—sex, hypochondriacal, religious, persecutory Incoherent speech Frequently deteriorates to the point of incontinence Pattern of severe disorganization progressing into emotional indifference and infantile behavior Prognosis is poor Alternate between catatonic immobility and wild excitement, though one may be predominant—pronounced symptoms are apparent Alternate between catatonic immobility and wild excitement, though one may be predominant—pronounced symptoms are apparent Can be violent Echolalia or echopraxia (mimic actions) Negativistic—resist instructions May recall actions of stupor later on Used to be a more common subtype, now less so here; still more common in less industrialized areas Stupor has been interpreted as way of coping or maintaining control Undifferentiated— Undifferentiated— Residual type Suffered at least one episode of schizophrenia, but not currently exhibiting any prominent positive or disorganized symptoms Prominent symptoms are negative Social withdrawal, impaired role functioning, blunted or inappropriate affect, lack of initiative, vague and circumstantial speech , impaired hygiene or grooming, odd beliefs or magical thinking Schizoaffective disorder Schizoaffective disorder Features of schizophrenia and a mood disorder (either bipolar or unipolar) Prognosis better than for schizophrenia alone Schizophreniform- Schizophrenia-like psychoses that last at least one month, but not as long as 6 months Most often seen in an undifferentiated form May or may not be related to subsequent psychiatric disorder Prognosis better than for schizophrenia Delusional disorder Other than delusions, behave normally Generally nonbizarre (could happen but aren’t) Brief psychotic disorder Brief psychotic disorder Sudden onset of psychotic, grossly disorganized, or catatonic sx Often lasts only days ; less than a month Often triggered by stress Returns to normal functioning Shared psychotic disorder (folie a deux) Dx when individual in a close relationship with a psychotic individual begins to believe same delusions May spread to an entire family Concordance rates: General pop 1% Concordance rates: General pop 1% Spouse 2% First cousin 2% Grandchild 5% Kids 6-9% Siblings 9% DZ 12-17% MZ 44-48% Studies of discordant MZ twins show that children of the well twin are at a significantly higher risk of developing schizophrenia (17% or so) Twin studies overestimate importance of genes because of shared environment. Adopted kids or schizophrenia parents—still at higher risk Multiple gene disorder—regions on chromosomes 22, 7, 8, and 1 Currently looking for candidate genes—genes known to be involved in some of the processes that are known to be problematic in schizophrenia Prenatal viral exposures—in Northern hemisphere , more are born in spring Prenatal viral exposures—in Northern hemisphere, more are born in spring 1957 flu epidemic in Finland—elevated rates of schizophrenia in children whose mothers had been in their second trimester Rhesus incompatibility Increased risk—for males, about 2.1% Mechanism may involve oxygen deprivation Prenatal birth complications Dutch hunger winter—conceived at ht of famine—2x increase in risk Unclear if this is general hunger or a specific nutrient Dostları ilə paylaş:
