DIAGNOSTIC TESTS Schizophrenia

Impulsiveness, Violence, Suicide and Homicide IMSULSIVENESS – Agitated, little impulse control – Decreased social sensitivity – Suicide and homicide attempts in response to hallucinations

Impulsiveness, Violence, Suicide and Homicide VIOLENCE. – Excluding homicide – Risk factors: Delusions of persecutory behavior Previous episodes of violence Neurologic deficits

SUICIDE – 50% of all schizophrenia patients attempt suicide (10-15% die by suicide) – Precipitants of suicide: Misdiagnosed depression Feelings of absolute emptiness Need to escape from mental torture Auditory hallucinations

Impulsiveness, Violence, Suicide and Homicide SUICIDE – Risk factors: Awareness of the illness, Male sex, College education, Young age A change in the course of the disease Improvement after a relapse Dependence on the hospital Overly high ambitions Previous suicide attempts early in the course of the disease Living alone

Impulsiveness, Violence, Suicide and Homicide HOMICIDE – Same incidence as in general population – Unpredictable or bizarre reasons based on hallucinations or delusions – Possible predictors: History of previous violence Dangerous behavior while hospitalized Hallucinations or delusions involving such violence

SENSORIUM AND COGNITION Diagnostic Tests

Orientation Usually oriented to person, time, and place Some may give incorrect or bizarre answers – “I am Christ; this is heaven; and it is AD 35.”