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SCHIZOPHRENIA 2 nd most frequent diagnosis of patients 14-64 y/o.

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Presentation on theme: "SCHIZOPHRENIA 2 nd most frequent diagnosis of patients 14-64 y/o."— Presentation transcript:

1 SCHIZOPHRENIA 2 nd most frequent diagnosis of patients 14-64 y/o

2 What is schizophrenia? A chronic severe brain disorder; often they hear voices, believe media are broadcasting their thoughts to the world or may believe someone is trying to harm them. In men it usually develops in teen years and early 20s; in women it usually develops in 20s and 30s.

3 Diagnosis Currently there is no physical or lab test that can absolutely diagnose schizophrenia. A psychiatrist usually comes to the diagnosis based on clinical symptoms.

4 Misdiagnosis This is a common problem since schizophrenia shares a significant number of symptoms with other disorders. Per the Nat’l Depression & Bipolar Support Alliance there is an average of 10 years from onset to correct diagnosis & tx.

5 Symptoms of Schizophrenia Profound disruption in cognition and emotion, affecting the most fundamental human attributes: –Language –Thought –Perception –Affect –Sense of self

6 Positive Symptoms Those that appear to reflect an excess or distortion of normal functions.

7 Positive Symptoms Delusions. Those where the patient thinks he is being followed or watched are common; also the belief that people on TV, radio are directing special messages to him/her.

8 Positive Symptoms Hallucinations. Distortions or exaggerations of perception in any of the senses. Often they hear voices within their own thoughts followed by visual hallucinations.

9 Positive Symptoms Disorganized thinking/speech. AKA loose associations; speech is tangential, loosely associated or incoherent enough to impair communication.

10 Positive Symptom Grossly disorganized behavior. Difficulty in goal directed behavior unpredictable agitation or silliness, social disinhibition, or bizarre behavior. There is a purposelessness to behavior.

11 Positive Symptom Catatonic behavior. Marked decrease in reaction to immediate environment, sometimes just unaware of surroundings, rigid or bizarre postures, aimless motor activity.

12 Other Positive Symptoms Inappropriate response to stimuli Unusual motor behavior (pacing, rocking) Depersonalization Derealization Somatic preoccupations

13 Summary of Positive Symptoms Delusions Hallucinations Disorganized thinking Disorganized behavior Catatonic behavior Inappropriate responses

14 FYI: Positive Symptoms Positive symptoms are those that have a positive reaction from some treatment. In other words, positive symptoms respond to treatment.

15 Types of Schizophrenia Paranoid Hebephrenic Catatonic Residual Schizoaffective Undifferentiated

16 Paranoid Schizophrenia Persons are very suspicious of others and often have grand schemes of persecution at the root of their behavior. During this phase they may have hallucinations and frequent delusions.

17 Hebephrenic Schizophrenia AKA disorganized schizophrenia; characterized by emotionless, incongruous, or silly behavior, intellectual deterioration, frequently beginning insidiously during adolescence. May be verbally incoherent and may have moods and emotions that are not appropriate to the situation. Hallucinations not usually present.

18 Catatonic Schizophrenia Person is extremely withdrawn, negative and isolated. May have marked psychomotor disturbances.

19 Residual Schizophrenia Lacks motivation and interest in day-to- day living. Person is not usually having delusions, hallucinations or disorganized speech.

20 Schizoaffective Disorder There will be symptoms of schizophrenia as well as mood disorder (depression, bipolar, mixed mania).

21 Undifferentiated Schizophrenia Conditions meeting the general diagnostic criteria for schizophrenia but not conforming to any of the previous types. Exhibits more than one of the previous types without a clear dominance of one.

22 Summary Before a diagnosis the psychiatrist must make a thorough evaluation including a physical/medical exam, a mental status exam, appropriate labs, and a full history. History includes changes in thinking, behavior, movement, mood, etc. as seen by the family.

23 These medications may have such intolerable side effects that the patient will stop the drugs. One study showed the average time the meds were taken regularly was 3 months.

24 Treatments Psychotherapy - an adjunct to meds and is very useful to keep the patient on the meds. Group therapy Family therapy Community support groups


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