SCHIZOPHRENIA
What is schizophrenia?
The causes of schizophrenia are multifactorial, ranging from idiopathic formulations, through biological correlates (genetic factors, monoamine hypothesis, neurodevelopmental abnormalities, environmental stressors), to mostly discounted hypotheses such as psychosocial, double-bind and expressed emotion (EE) theories.
What is the diagnostic criteria of schizophrenia?
- >= 2 symptoms <= month or less if treated:
delusions, hallucinations, disorganized speech (incoherence) and behavior, negative symptoms (diminished emotional expression) OR 1 bizarre delusion OR running commentary OR >= 2 voices in conversation - Function (failure to achieve expected interpersonal
or academic achievement in children and adolescents, or significant decline in work, interpersonal or self-care functioning in adults) - 6-month duration (continuous)
- Mood symptoms, if present, are brief relative to other symptoms
- Not secondary to substance or medical condition
- If PDD, need hallucinations or delusions
what do the individual, family or friends usually notice before the first psychotic episode, or in the so-called schizophrenia prodrome?
- Social isolation and anxiety
- Deterioration in role function (school)
- Attenuated or brief psychotic symptoms (illusions, overvalued ideas, suspiciousness)
- Nonspecific symptoms (anxiety, depression, irritability, apathy, withdrawal, lack of initiative and sleep disturbances)
- Estimated length of prodrome = 4 years
- Prodromal patients have a 30-40% risk of developing psychosis in ~ 2 years.