Schizophrenia - Psychiatry medicine

Question 1

Definition of Schizophrenia

Answer 1

• is a clinical syndrome of variable but profoundly disruptive psychopathology that involves (cognition, thinking, perception, emotion, and behavior) in which patients have psychotic symptoms and social or occupational dysfunction that persists for at least 6 months.
• Usually before the age of 25, persists throughout life, affects persons of all social classes.

Question 2

Diagnosis of schizophrenia (Important)

Answer 2

A. Two or more of the following must be present:
1) Hallucinations
2) Delusions
3) Disorganized behavior
4) Disorganized speech
5) Negative symptoms

B. The symptoms must last at least for 6 months.

C. Presence of significant occupational and or social dysfunction.

D. The condition is not substance induced or due to general medical condition.

Question 3

clinical subtypes of schizophrenia

Answer 3

1- Paranoid type:
* One or more delusions or frequent auditory hallucinations.
2- Disorganized type:
* Disorganized speech.
* Disorganized behavior.
3- Catatonic type:
Motoric immobility or stupor. Excessive motor activity (purposeless and not influenced by ex. stimuli). Extreme negativism or mutism.
Peculiarities of voluntary movements (stereotyping, grimacing, posturing). Echolalia or echopraxia.
4- Undifferentiated type:
* Criteria are not met for paranoid, disorganized, or catatonic subtypes.
5- Residual type:
* Residual negative symptoms or attenuated positive symptoms.

Question 4

Ttt of schizophrenia

Answer 4

• Hospitalization
• Pharmacotherapy
  1. Typical antipsychotics: (Dopamine receptor antagonist)
  Examples: trifluperazine, haloperidol, chlorpromazine and thioridazine.
  Side effects: Acute dystonia, Neurleptic malignant syndrome, Parkinsonism, Hyperprolactinemia, orthostatic hypotension, Dry mouth and constipation.

2. Atypical Antipsychotics: (Serotonin and dopamine antagonists)
   Examples:
   ● Risperidone, olanzapine, clozapine, & quetiapine.
   Side effects:
   ● Milder motor side effects.
   ● But others (weight gain, diabetes).

Question 5

Indications of electro-convulsive therapy

Answer 5

• Acute schizophrenia especially paranoid, catatonic, prominent affective symptoms.
• Treatment resistant schizophrenia
• Considerable suicide risk.