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Diagnosis and Discussion

Schizophrenia is a chronic psychotic disorder typically emerging in adolescence or young adulthood, marked by varying disturbances in thinking, behavior, and perception. Its severity can range from mild dysfunction to severe impairment requiring constant supervision. The condition’s prevalence is about 1% in the U.S., affecting both genders equally, though onset is earlier in men. Symptoms vary over time and may include positive and negative symptoms, with factors like genetics and brain structure playing significant roles in its etiology. Understanding premorbid signs can aid in diagnosis and treatment.

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Diagnosis and Discussion

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  1. Diagnosis and Discussion

  2. Schizophrenia • chronic psychotic disorder with onset typically occurring in adolescence or young adulthood • results in fluctuating, gradually deteriorating, or relatively stable disturbances in thinking, behavior, and perception • severity can range from mild and subtle with very good adaptation to everyday life, to severely disabling requiring constant supervision in a restricted environment.

  3. Classification of Longitudinal Course

  4. Epidemiology • US lifetime prevalence: 1% • DSM-IV-TR: annual incidence 0.5-5.0 per 10,000 • Equally prevalent in men and women. • Earlier onset in men (10-25 yrs old), women (25-35) • Men are more likely to be impaired with negative symptoms • Women have better social functioning prior to disease onset

  5. ETIOLOGY

  6. Pathophysiology Dopamine Hypothesis

  7. Examples of Positive and Negative Symptoms in Schizophrenia

  8. Increased rate among the biological relatives of patients with schizophrenia • Correlated with the closeness of the relationship to an affected relative

  9. Neuropathology • Loss of brain volume results from reduced density of the axons, dendrites and synapses that mediate associative functions of the brain.

  10. CLINICAL FEATURES • No clinical sign or symptom is pathognomonic for schizophrenia • Patient’s symptoms change with time • Clinicians must take into account the patient’s educational level, intellectual ability and cultural and subcultural membership.

  11. Premorbid Signs and Symptoms • Appear before the prodromal phase of the illness • Patients had schizoid or schizotypal personalities. • Quiet, passive, and introverted • As children, they had few friends • Signs may have started with complaints about somatic symptoms • Headache, back and muscle pain, weakness and digestive problems

  12. Family and friends may notice that the patient has changed and no longer functioning well in occupational, social, and personal activities. • May begin to develop an interest in abstract ideas, philosophy and the occult or religious questions • Include markedly peculiar behavior, abnormal affect, unusual speech, bizarre ideas and strange perceptual experiences.

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