Schizophrenia Spectrum and other Psychotic Disorders
Schizophrenia Spectrum and other Psychotic Disorders
- The word schizophrenia is derived from the Greek words skhizo (split) and phren (mind).
- The diagnosis of schizophrenia is commonly misinterpreted as a split personality.
- Schizophrenia is probably caused by a combination of factors, including:
- Genetic predisposition
- Biochemical dysfunction
- Physiological factors
- Psychosocial stress
- Schizophrenia requires treatment that is comprehensive and presented in a multidisciplinary effort.
- Of all mental illnesses, schizophrenia probably causes more:
- Lengthy hospitalizations
- Chaos in family life
- Exorbitant costs to people and governmentsÂ
- Fears
Nature of the Disorder
- Schizophrenia causes disturbances in:
- Thought processes
- Perception
- Affect
- With schizophrenia, there is a severe deterioration of social and occupational functioning.
- In the United States, the lifetime prevalence of schizophrenia is about 1%.
- Premorbid behavior of the patient with schizophrenia can be viewed in four phases.
Phase 1
- Premorbid phase
- Shy and withdrawn
- Poor peer relationships
- Doing poorly in school
- Antisocial behavior
Phase 2
- Prodromal phase
- Lasts from a few weeks to a few years
- Deterioration in role functioning and social withdrawal
- Substantial functional impairment
- Depressed mood, poor concentration, fatigue
- Sudden onset of obsessive-compulsive behavior
Phase 3
- Acute schizophrenic episode
- In the active phase of the disorder, psychotic symptoms are prominent.
- Delusions
- Hallucinations
- Impairment in work, social relations, and self-care
Phase 4
- Residual phase
- Symptoms similar to those of the prodromal phase.
- Flat affect and impairment in role functioning are prominent.
Prognosis
Factors associated with a positive prognosis
- Good premorbid functioning
- Later age at onset
- Female gender
- Abrupt onset precipitated by a stressful event
- Associated mood disturbance
- Brief duration of active-phase symptoms
- Minimal residual symptoms
- Absence of structural brain abnormalities
- Normal neurological functioning
- No family history of schizophrenia