13. Schizophrenia

Question 1

……..it’s a syndrome or a disease process with many different varieties and symptoms.

Answer 1

Schizophrenia

Question 2

• According to DSM 5, the onset of this disease - usually occurs between the late teens and the mid 30s.
• The prevalence is about the same in men & women.
• The onset is later in women than in men.
• The clinical course is less severe in women than in men.

Answer 2

Schizophrenia

Question 3

What is the age & sex risk factors of developing Schizophrenia?

Answer 3

Age: usually diagnosed under 45, start before 25 (50 %).

Sex: between the ages of 15-25 in male & 25-35 in women.

Question 4

Factors which are responsible for a good prognostic outcome of schizophrenia are:

Answer 4

Age of the patient – The older the patient, the more favorable the prognosis.

The duration of illness – The shorter the duration prior to treatment, the better the outcome.

The rapidity of development of the symptoms – the more speedily the symptoms develop, the faster do they respond to treatment; a very slow, insidious, and gradual onset of illness suggests a final poor outcome.

A patient who had close friendships and multiple relationships prior to illness has a brighter chance with few or no such relationships.

Marital history – A patient with a stable and helpful marital partner has a favorable prognosis as compared to an unmarried patient.

Educational history – The higher the level of education, the more are the chance of a patient coming rapidly to terms with the illness and handling the post-illness sequence.

Occupational history – A patient with a good stable occupation or business prior to onset of illness will respond better than a patient who is jobless and economically unsound.

Family’s attitude towards the returning patient – Hostile behavior by family members, or vice versa, excessive care and attention by them can undermine the patient’s sense of confidence and hamper recovery.

Social support systems – A patient with a joint family and a staunch circle of friends who are ready lend a helping hand, is much better off than a lone man afflicted with the illness, whose relatives are in some far off land, and who has no one to turn to.

Organic brain damage – Presence of concurrent obvious brain damage (mental retardation, epilepsy, head injury, etc.) hinders the final adequate recovery from schizophrenia.

Question 5

Positive Symptoms - symptoms that most individuals do not normally experience but are present in schizophrenia:

Answer 5

Hallucinations
Delusions
Bizarre Behavior
Paranoia
All are regarded as manifestations of psychosis.

Question 6

Negative Symptoms - are normally found in healthy persons - NS reflect the loss or absence of normal traits or abilities:
:

Answer 6

Apathy - indifference, is a lack of feeling, emotion, interest, or concern about something.

Avolition - total lack of motivation that makes it hard to get anything done.

Bland /Flat Affect - feel emotions but show nothing visually.

Waxy Flexibility - uncomfortable positions.

Posturing - voluntary assumption of inappropriate or bizarre postures.

Alogia - speak less, say fewer words or only speak in response to others.

Anhedonia - inability to experience joy or pleasure.

Pacing and Rocking - pacing back and forth and body rocking (a slow, rhythmic, backward- and-forward swaying of the trunk from the hips, usually when sitting) are common psychomotor behaviors of the client with schizophrenia.

Impaired Social Interaction

Social Isolation

Anergia - lack sufficient energy.

Question 7

Antipsychotic medications, also known as_______are used for the treatment and management of symptoms associated with various psychiatric disorders.

Answer 7

Neuroleptics

• Antipsychotics target the
  positive signs of schizophrenia, such as delusions, hallucinations, disturbed thinking, and other psychotic symptoms, but have no observable effect on the negative signs.
• The atypical antipsychotics not only diminish positive symptoms.