Schizophrenia2 symptomatology
Prof .Dr Elham Aljammas 13l11l2013Features of Schizophrenia
Positive symptoms Delusions HallucinationsCognitive deficits Attention Memory Verbal fluency Executive function (eg, abstraction)
Functional Impairments Work/school Interpersonal relationships Self-care
Negative symptoms Anhedonia Affective flattening Avolition Social withdrawal Alogia
Mood symptoms Depression/Anxiety Aggression/Hostility Suicidality
Disorganization Speech Behavior
Behaviour : ِ Acute stage: Varied : (mute,withdrawn,entirely wrapped up in their abnormal experience ,Violent.Bizzare)some adopt strange posture (catatonia)or (catatonic excitement)Seem to respond to their Hall.i.e looking around.Neglecting their personal hygiene
Affect: Highly aroused Bewildered mused Incongruent affect Flattening or blunting of affect
Speech: Seem to echo their thought pattern,i.e difficult to be understood. Knight's move thinking Neologisms Clang association Word salad
Thought:Delusions-Persecutory hearing),Delusion of referencePrimary delusion Delusion of perceptionThoughts-thought broadcastingThought insertionThought withdrawalThought echoPassivity feeling –somatic,action,mood.Hallucinations:in all sensory modalities.Most common auditory hall. (several voices)Visual,less common& suggest organic causeInsight:Frequently sch. Patient do not agree that they are unwell
Chronic schizophrenia:(negative symptoms,type 11) Is chronic relapsing illness with episode of acute disturbance Apathy or loss of volition Flattening of affect Poverty of speech Poor prognosis Increased vent. Brain ratio. Soft neurological signs,& cognitive impairment(disorientation)
Subtypes of schizophrenia: 1. Paranoid 2.Disorganized 3. catatonic 4.Simple
paranoid: commonest,delusion or hallucinations No major disturbances of speech or of behaviour Disorganized: Disorganized speech & behaviour Inappropriate affect is commonCatatonic: Disturbances of motor activities(stupor,waxy flexibility,period of immobility may alternate with extreme overactivity,echolalia,echopraxia,&negativism)
Simple: Keep a distance from social relationship,few interest & pleasure in life,emotionally cold & flat.
Aetiology of schizophrenia: 1.abnormality of dopamine metabolisim 2.environmental theories 3.genetic 4.social theory
Abnormality of dopamine turnover increase level of D.A.,increased DA receptors. Environmental theory Season of birth ( early months of the year ) influenza virus Birth trauma
Genetics 60% of schizophrenic have no family historyof the illness if one parent hase schiz. There is15%chance of their children to develop the illness,46%if both. Fertility of sch.is low. Adoption studies higher than control