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schizophreniaPsychiatry A heterogenous group of disorders characterized by progressive mental disturbances in thought, perception, affect, behavior, and communication that last longer than 6 months, which may be accompanied by psychotic Sx, bizarre behavior, or by negative–deficit Sx, including low levels of emotional arousal, mental activity, and social drive; schizophrenia is a diagnosis of exclusion–none of its clinical, biochemical, neuroradiologic, pathophysiologic, and psychologic features are sufficient to establish a definitive diagnosis DSM-IV Clinical Disordered thought processes and abnormal behavior–eg, hallucinations, delusions, social withdrawal, inappropriate or "blunted" affect, verbal incoherence, cognitive deficits, inappropriate or blunted affect Types Catatonic, paranoid, disorganized, undifferentiated, residual Management Antipsychotics are used to
1. ↓ hallucinations and delusions, and other thought disturbances and improve Sx of withdrawal and apathy.
2. Control Sx through maintenance therapy, and.
3. As long-term prophylaxis, neuroleptics include haloperidol and clozapine See Cultural schizophrenia, Disorganized schizophrenia, Fugue, Multiple personality, Paranoid schizophrenia. Cf Schizoid personality disorder.
A Characteristic Sx: 2 or more2 of following, for a significant portion of 1+ months
Disorganized (or catatonic) behavior
Disorganized speech (incoherence)
Negative symptoms, eg flattening of affect, loss of volition
B Social/occupational dysfunction
C Duration 6+ months in duration with 1+ months of 'active' symptoms, defined by criteria A
Exclusions Symptoms are not better accounted for by
D Other mental disorders, eg Schizoaffective disorder or Mood disorder with psychotic features
E Other conditions, eg substances(medication, substance of abuse) and/or general medical conditions
1Modified from Diagnostic & Statistical Manual of Mental Disorders, 4th ed, Washington, DC, Am Psychiatric Assn, 1994
2Only one of criteria A is required if the delusions are bizarre, or hallucinations include 1 + 'voices in head'
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