A psychotic disorder (or a group of disorders) marked by severely impaired thinking, emotions, and behaviors.
A group of psychotic disorders characterized by both positive and negative symptoms associated with disturbance in one or more major areas of functioning, such as work, academic development or achievement, interpersonal relations, and self-care. Positive symptoms include delusions, which may be bizarre in nature; hallucinations, especially auditory; disorganized speech; inappropriate affect; and disorganized behavior. Negative symptoms include flat affect, avolition, alogia, and anhedonia. Duration is variable: icd-10 requires that continuous signs of the disturbance persist for at least 1 month; dsm-iv-tr requires a minimum of 6 months. Some of the subtypes are as follows:
- Catatonic Abnormal motor activity dominates the clinical picture. This may take the form of motor immobility, catalepsy, waxy flexibility, or stupor; extreme agitation with purposelessness and excessive motor activity; extreme negativism and resistance or mutismpeculiar movements such as posturing, stereotyped movements, prominent mannerisms, or grimacing; and echolalia or echopraxia. A marked psychomotor disturbance which may involve particular forms of stupor, rigidity, excitement, or posturing. Sometimes where there is a rapid alternation between the extremes of excitement and stupor, associated features include negativism, stereotypy, and waxy flexibility. Mutism is common.
- Disorganized Formerly called hebephrenic schizophrenia. Disorganized speech and behavior and inappropriate affect dominate the clinical picture; if present at all, delusions and hallucinations are fragmented.
- Paranoid Delusions or hallucinations dominate the clinical picture.
- Undifferentiated No one of the above clinical presentations predominates.
- Residual Persistence of some symptoms but not of sufficient number or intensity to indicate that the patient is in an active phase. The existing symptoms may be only negative (e.g., social isolation, impaired grooming, blunted affect, poverty of speech, lack of energy or initiative), but there also may be unusual behavior, vague and circumstantial speech, odd beliefs or magical thinking, or unusual perceptual experiences. Patients who develop depression (i.e., depressed mood plus other symptoms of a major depressive episode) during the residual phase are labeled as having postpsychotic depression of schizophrenia.
- Childhood Schizophrenia appearing before puberty. Frequently manifested by autism and withdrawn behavior; failure to develop an identity separate from the mother’s; general unevenness, gross immaturity, and inadequacy in development.
- Disorganized (hebephrenic) Characterized by dis- organized thinking, shallow and inappropriate affect inappropriate giggling, silly and regressive behavior and mannerisms, and frequent hypochondriacal com- plaints. Delusions and hallucinations are usually bizarre and disorganized.
- Latent Clear symptoms of schizophrenia but no history of psychotic schizophrenic episodes. Sometimes designated as incipient, pre-psychotic, pseudoneurotic, pseudo-psychopathic, or borderline schizophrenia.
- Paranoid Characterized by a persistence of or preoccupation with persecutory or grandiose delusions, or hallucinations with a persecutory or grandiose content. In addition, there may be delusions of jealousy.
- Process Attributed more to organic factors than to environmental ones; typically begins gradually, continues chronically, and progresses (either rapidly or slowly) to an irreversible psychosis. Contrast with reactive schizophrenia.
- Reactive Attributed primarily to strong predisposing and/or precipitating environmental factors; usually of rapid onset and brief duration, with the affected individual appearing well both before and after the schizophrenic episode. Differentiating this condition from process schizophrenia is generally considered more important in Europe than in this country. Schizophreniform disorder is conceptually similar.
- Residual A condition manifested by persons with signs of schizophrenia who, following a psychotic schizophrenic episode, are no longer psychotic.
- Undifferentiated A condition manifested by definite signs of schizophrenic thought, affect, and behavior that are of a sufficiently mixed or indefinite type that they defy classification into one of the other types of schizophrenia.
- Acute Characterized by sudden onset of symptoms, often associated with confusion, perplexity, ideas of reference, emotional turmoil, excitement, depression, fear, or dreamlike dissociation.
A group of psychiatric disorders in which thinking, emotions, and behavior are disrupted and the person is often delusional. A symptom of schizophrenia is hallucination, which is often auditory (“hearing voices”) rather than visual.
A psychosis with multidimensional symptoms, such as withdrawal, personality regression, and deterioration of emotional responses. Formerly, for diagnostic purposes, was divided into seven distinct classic types. However, since tends to transit from one type to another during various phases of the psychosis, psychiatrists today are reluctant to use these diagnostic classes. Some forms of manifest symptoms that are gradual, resulting in personality changes characterized by extreme emotionality, lack of interest, and withdrawal. Other forms may manifest symptoms of delusions, silliness, regression, and catatonia.
A mental disorder in which someone withdraws from contact with other people, has delusions and seems to lose contact with the real world.
A group of mental disorders that have in common widespread disturbances in thinking, behavior, and emotional reactions, especially lack of relation between thoughts and feelings. It is this split that gives the disorder its popular name, split personality (a term also applied to multiple personality disorder, where the split is quite different, being between two or more personalities). Often young people with schizophrenia are so disoriented as to be unable to function on a day- to-day basis and need to have supervision to be sure that the daily necessities of life are met and that they do not come to— or cause—harm.
Any of a group of mental disorders characterized by gross distortions of reality, withdrawal from social contacts, and disturbances of thought, language, perception, and emotional response. Symptoms are highly varied and may include apathy, catatonia or excessive activity, bizarre actions, hallucinations, delusions, and rambling speech. Some cases are mild; others severe, requiring prolonged or permanent hospitalization. There is no known cause; a combination of hereditary or genetic pre-disposition factors is likely responsible in most cases.
A major psychiatric disorder with chronic loss of connection with reality in most or all aspects of life; includes bizarre behavior, disrupted thought processes, hallucinations and delusions of persecution, and alterations in speech.
A severe mental illness characterized by persistent, bizarre disturbances in thought, communication, perceptions, emotions, and behavior. Schizophrenia is considered a psychosis because people with the disease become detached from reality.
A severe mental disorder (or group of disorders) characterized by a disintegration of the process of thinking, of contact with reality, and of emotional responsiveness. Delusions and hallucinations (especially of voices) are usual features, and the patient usually feels that his thoughts, sensations, and actions are controlled by, or shared with, others. He becomes socially withdrawn and loses energy and initiative. The main types of schizophrenia are simple, in which increasing social withdrawal and personal ineffectiveness are the major changes; hebephrenic, which starts in adolescence or young adulthood; paranoid, characterized by prominent delusions; and catatonic, with marked motor disturbances.
An overall title for a group of psychiatric disorders typified by disturbances in thinking, behaviour and emotional response. The illness is disabling, running a protracted course that usually results in ill-health and, often, personality change. Schizophrenia is really a collection of symptoms and signs, but there is no specific diagnostic test for it. Similarity in the early stages to other mental disorders, such as manic depression, means that the diagnosis may not be confirmed until its response to treatment and its outcome can be assessed and other diseases excluded. Despite its inaccurate colloquial description as ‘split personality’, schizophrenia should not be confused with multiple personality disorder.
A thought disorder affecting about 0.4% to 1.2% of the population, marked by delusions, hallucinations, and disorganized speech and behavior (the “positive” symptoms) and by flat affect, social withdrawal, and absence of volition (the “negative” symptoms). Schizophrenia involves dysfunction in one or more areas such as interpersonal relations, work or education, or self-care. Associated features include inappropriate affect, anhedonia, dysphoric mood, abnormal psychomotor activity, cognitive dysfunction, confusion, lack of insight, and depersonalization. Abnormal neurological findings may show a broad range of dysfunction including slow reaction time, poor coordination, abnormalities in eye tracking, and impaired sensory gating. Some individuals drink excessive amounts of water (water intoxication) and develop abnormalities in urine specific gravity or electrolyte imbalance. Because none of its clinical features are diagnostic, schizophrenia remains a diagnosis of exclusion. It is important to exclude psychoses with known organic causes such as temporal lobe epilepsy, metabolic disturbances, toxic substances, or psychoactive drugs. The onset of schizophrenia typically occurs between the late teens and the mid-30s; onset prior to adolescence is rare. Gender differences suggest that women are more likely to have a later onset, more prominent mood symptoms, and a better prognosis. Hospital-based studies show a higher rate of schizophrenia in men, whereas community-based studies suggest an equal sex ratio.
A serious mental disorder characterized by unpredictable disturbances in thinking, mood, awareness, and behavior.
An incapacitating psychiatric disorder, marked by the presence of delusions, hallucinations, incoherent speech and actions, as well as an absence of emotional expression, severely impairs regular functioning.
A broad classification for a set of psychotic disorders (conditions in which an individual becomes detached from reality) marked by disruptions in thinking, emotional responses, and conduct. Schizophrenia is a debilitating condition with a protracted trajectory that typically leads to enduring health challenges and a certain level of personality alteration.
Symptoms can emerge at any stage of life, though they frequently manifest during the late teenage years and early twenties. The underlying causes remain uncertain, although various factors have been suggested. Genetic inheritance is likely to contribute to the condition. Disturbances in the functioning of certain neurotransmitters (substances that transmit signals between nerve cells) within the brain are proposed as a potential mechanism. Brain imaging has disclosed structural and functional irregularities in individuals affected by this disorder.
Schizophrenia can initiate subtly, with a gradual decline in social engagement and motivation. Alternatively, it can manifest suddenly, often triggered by external stressors. Key indicators include delusions (fixed and irrational beliefs), such as those associated with paranoid schizophrenia; hallucinations (perceptions occurring without external stimuli); and disturbances in thought patterns. Hallucinations typically involve auditory experiences (hearing voices discussing the individual), but can also be visual or tactile. Disordered thinking leads to difficulties in concentration and cognitive processes, often evident through incoherent speech and unusual responses. Individuals might believe their thoughts are manipulated by external influences or broadcasted to others.
As the condition advances, the individual’s emotions tend to dull, accompanied by a growing sense of detachment from others and a waning interest in customary activities. Behavior becomes increasingly idiosyncratic, often accompanied by neglect of oneself. In a less common manifestation of schizophrenia, catatonia might emerge. This state involves adopting rigid postures for extended periods or experiencing repeated bursts of movement.
Diagnosing schizophrenia can sometimes be a lengthy process, and there are instances where arriving at a definitive diagnosis proves challenging. Treatment primarily revolves around antipsychotic medications, including phenothiazine drugs and newer atypical antipsychotics like risperidone. For some cases, these medications are administered through monthly depot injections. Once symptoms are managed, a combination of community support, vocational prospects, and family counseling can contribute to averting relapse.
While a complete recovery is achievable for certain individuals, the majority of those affected experience relapses interspersed with periods of partial or complete recovery. A small percentage of individuals endure a significant, lifelong impairment.
A chronic mental disorder, usually of young people or young adults, characterized by one or more of the following patterns of behavior: (1) Introversion. The patient is reticent, a poor mixer, sensitive, and passively stubborn, shows little interest in what goes on around him and lives in a world of fantasy. (2) Mental disintegration. Although he may well be intelligent, the patient lacks the capacity to apply himself to his studies, his work, or to well directed logical thought. Instead, he may behave hysterically or be childish and silly. His conduct becomes meaningless, unexpected, and inconsistent. (3) Paranoid trends. He becomes suspicious and thinks everybody and the world in general are against him. He hears imaginary voices, and, as his condition worsens, he suffers from hallucinations and delusions. Also called dementia praecox.