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Definition
A group of psychotic disorders characterized by disturbances in
thought, perception, affect, behavior, and communication that last
longer than 6 months.
Causes, incidence and risk factors
The cause of schizophrenia is unknown. There are various theories to
explain the development of this disorder. Genetic factors may play a
role, as close relatives of a person with schizophrenia are more
likely to develop the disorder. Psychological and social factors,
such as disturbed family and interpersonal relationships, may also
play a role in development . There are 5 recognized types of
schizophrenia: catatonic, paranoid, disorganized, undifferentiated,
and residual. Features of schizophrenia include its onset before the
age of 45; continuous presence of symptoms for 6 months or more; and
deterioration in functioning involving care of self, work, or social
relationships.
Psychotic symptoms are present during the active phase and may
include 2 or more of the following:
- delusions - unfounded beliefs
that are thought to be true even in the face of contradictory
evidence
- hallucinations - a sensory
perception without an external stimulus; may affect hearing,
taste, vision, smell, or sense of touch
- incoherence (not
understandable) - disordered, and without logical connection
- catatonic behavior - bizarre
motor behavior marked by a decrease in reactivity to the
environment, or hyperactivity that is unrelated to stimulus
- flat affect - an appearance or
mood that shows no emotion
No single characteristic is present in
all types of schizophrenia. The risk factors include a family
history of schizophrenia. Schizophrenia is thought to affect about
1% of the population. Childhood-onset schizophrenia begins after 5
years of age. It can be difficulty to differentiate from autism.
Childhood-onset schizophrenia occurs equally in boys and girls.
Often, there is a strong family history of schizophrenia.
Prevention
There is no known prevention.
Symptoms
Catatonic type:
- motor disturbances
- stupor
- negativism
- rigidity
- excitement
- may be unable to take care of
personal needs
- decreased sensitivity to
painful stimulus
Paranoid type:
- delusional thoughts of a
persecution or grandiose nature
- anxiety
- anger
- violence
- argumentative
Disorganized type:
- incoherence (not
understandable)
- regressive behavior
- flat affect
- delusions
- hallucinations
- inappropriate laughter
- mannerisms
- social withdrawal
Undifferentiated type:
- may have symptoms of more than
one subtype of schizophrenia
Residual type:
- the prominent symptoms of the
illness have abated but some features, such as hallucinations
and flat affect, may remain
Signs and tests
The diagnosis of this disorder is difficult and controversial.
The following factors may aid in the diagnosis but do not confirm
it:
- developmental background
- genetic and family history
- current stress factors for the
affected individual
- level of functioning prior to
illness
- course of illness
- response to therapy
- CT scan of the head may reveal
enlarged ventricles in the brain
Treatment
Hospitalization is often required to prevent self-inflicted harm or
harm to others, and to provide for the person's basic needs such as
food, rest, and hygiene.
Antipsychotic or neuroleptic medications are used to control the
symptoms of the illness. This group of drugs includes the
phenothiazines, thioxanthenes, butyrophenones, dihydroindolones, and
dibenzoxazepines. Drug treatment is continuous, as relapse of
symptoms is common when medication is discontinued.
Psychotherapy may be helpful in certain situations. Family therapy
is often helpful to assist relatives in coping with the affected
individual.
Behavioral techniques used in a therapeutic setting, or in the home
can help a person learn behaviors that will lead to social
acceptance.
Expectations (prognosis)
Most people with this disorder are improved with medication,
however, many are not able to function in a productive capacity.
Group homes or structured living environments are beneficial for
many individuals.
Complications
- non-compliance with medication
will lead to a relapse of symptoms
- physical illness may go
undetected because the patient may not
complain of pain or symptoms
Calling your health care
provider
Call your health care provider or mental health professional if:
- voices are telling you to hurt
yourself.
- you are unable to care for
yourself.
- you are feeling hopeless and
overwhelmed.
- you feel like you cannot leave
the house.
- you are seeing things that
aren't really there.
Healthcentral
2004
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2005 Georges G. Hayek. All rights reserved |
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