What percent of schizophrenic patients have substance abuse disorders?
What percent of schizophrenic patients will not respond to medication?
What percent of homeless population in US are schizophrenic?
At what age do most schizophrenics develop the disorder (75%)?
What is the psychoanalytic theory of schizophrenia?
failure of repression and flooding of unconscious content
What is the neurochecmical theory of schizophrenia?
Brain overproduction of dopamine and decreased blood flow to frontal cortex
What is the viral theory of shcizophrenia?
prenatal exposure to influenza virus
What are genetic theories of schizophrenia?
- people have schizophrenic gene
- activated by early childhood life or trauma experience
What brain changes are shown on MRI, CAT Scans and PET?
- enlargement of lateral cerebral ventricles
- cortical atrophy
- third ventricular dilation
- ventricular asymmetry
- cerebella atrophy
What symptoms might patient report before first episodic break?
- mind wandering
- difficulty concentrating
- unwanted intrusive thoughts
- misinterpreting things
- finding mystical/symbolic meanings
- mistakes others as having harmful intent
What are s/s as the disease develops?
- feels rejected
- lonely, hopeless
- withdraws emotionally & isolates
- unable to trust others
- withdraws from reality: hallucinations, delusions
- odd mannerisms
- think thoughts are controlled or broadcast
- hear voices
- preoccupied with religion, mysticism, metaphysical
When does a schizophrenic individual have a better prognosis?
When disease comes on fast and very sick
Describe a paranoid type
- Delusions-persecutory and grandiose and may be organized around a theme
- Associated features-anxiety, anger, aloofness, argumentativeness
- May have patronizing, superior, a stilted or formal quality
- Highly suspicious
Describe catatonic type.
- Motor immobility or stupor, waxy flexibility
- Excessive motor activity, purposeless
- Negativism-moveless resistance, mute
- Peculiarities of voluntary movement-posturing, prominent mannerisms and grimacing
- Echolalia and Echopraxia
- Disorganized speech.
- Disorganized behavior.
- Flat or inapproaite affect.
- Absent are prominent hallucinations, disorganized speech, disorganized behavior or catatonia
- Has negative symptoms
- -flattened affect
- -alogia (inability to sleep)
Describe undifferentiated type.
Does not meet any s/s of any other type of schizophrenia and schizophrenic symptoms are present: delusions, hallucinations, neg sx
What is a brief psychotic rx?
- Not schizophrenia
- One or more of:
- -disorganized speech
- -disorganized behavior
- -duration: 1 day to 1 month
- -with or without marked stressor present
What is assessed in the Mental Status Exam?
- Thought process and Content