Schizophrenia

A psychotic disorder in which personal social and occupational functioning deteriorate as a result of strange perception, disturbed thought process unusual emotions and motor abnormalities.

Symptoms:

graphr of schizophi

Inappropriate Affect

  • Incoherent
  • Faulty Thinking
  • Faulty Perception
  • Distortion
  • Dysfunction
  • Deterioration in Mood Behavior
  • Faulty Self Image
  • Ignorance of Hygiene
  • Suicidal Tendency

Types of Schizophrenia:

  • Paranoid Type
  • Catatonic Type
  • Disorganized Type
  • Un Differentiated Type
  • Residual Type

Paranoid Type:

In this type the presence of prominent delusions or auditory hallucinations.

Criteria:

  • Preoccupation with one or more delusions or frequent auditory hallucinations.
  • None of the following is prominent: disorganized speech. Catatonic behavior or flat or inappropriate affect.

Catatonic Type:

Psychomotor disturbance that may involve monotonic immobility, excessive motor activity, extreme negativism (waxy flexibility)

Criteria:  (two or more from following)

  • Motoric immobility as evidenced by catalepsy (waxy flexibility).
  • Extreme motor activity (maintenance of rigid posture against attempts to be moved).
  • Peculiarities of voluntary movement as evidenced by posturing.

Disorganized Types:

Disorganized speech and behavior, flat or inappropriate affect. The disorganized speech may be accompanied by silliness and laughter that are not closely related to the content of the speech (lack of goal orientation, showering).

Criteria:

All of the following are prominent:

  • Disorganized Speech
  • Disorganized Behavior
  • Flat or inappropriate affect

The criteria are not met for catatonic type.

Un-Differentiated Type:

Is the presence of symptoms that meet criterion A of schizophrenia but that do not meet criteria for the paranoid, disorganized or catatonic type.

Criteria:

Symptoms that meet criterion are present, but the criteria are not met for the Paranoid, Disorganized or Catatonic type.

Residual Type:

Once the patient has been fit but after some time the symptoms appear again.

Criteria:

  • Absence of prominent delusions, hallucinations, disorganized speech and catatonic behavior.
  • There is continuing evidence of the disturbance, as indicated by the presence of negative symptoms or two or more symptoms.

Etiology

  • Adoption studies show a strong relationship between having a parent with schizophrenia and the likelihood of developing the disorder typical in early adulthood.
  • The genetic predisposition to develop schizophrenia may involve neurotransmitters. The negative symptoms may be due to dopamine problems in the prefrontal cortex. Other neurotransmitters like glutamate and GABA may be involved.
  • The brain of some people has enlarged ventricles and problem with the prefrontal cortex. Those cause abnormalities.

Treatment:

Medication

  1. First-generation Antipsychotic Drugs
  2. Second-generation Antipsychotic drugs

Psychological Treatment

  1. Educating people with schizophrenia about relapse and recognizing early sign of relapse.
  2. Monitoring early signs of relapse by staff
  3. Weekly supportive group of individual therapy
  4. Family educational sessions
  5. Quick intervention, involving both increased doses of medication and crisis-oriented problems-solving therapy.

Case Management

Residential Treatment

Cognitive Behavior Therapy

Social Skill Training

Family Therapy

  1. Hope
  2. Social network expansion
  3. Education about schizophrenia
  4. Information about anti-psychotic medications
  5. Communication and problem solving skill with the family

 

Clinical Psychologist Umar Raza