Schizophrenia

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May be verbally incoherent and may have moods and emotions that are not appropriate to the situation.

Hallucinations not usually present.

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Catatonic Schizophrenia

Person is extremely withdrawn, negative and isolated.

May have marked psychomotor disturbances.

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Residual Schizophrenia

Lacks motivation and interest in day-to-day living.

Person is not usually having delusions, hallucinations or disorganized speech.

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Schizoaffective Disorder

There will be symptoms of schizophrenia as well as mood disorder (depression, bipolar, mixed mania).

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Undifferentiated Schizophrenia

Conditions meeting the general diagnostic criteria for schizophrenia but not conforming to any of the previous types.

Exhibits more than one of the previous types without a clear dominance of one.

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Summary

Before a diagnosis the psychiatrist must make a thorough evaluation including a physical/medical exam, a mental status exam, appropriate labs, and a full history.

History includes changes in thinking, behavior, movement, mood, etc. as seen by the family.

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Medications

In general it may take up to 6 months for medications to show consistent effects.

The newest medication is Invega.

Meds include atypicals: Abilify, Geodon, Clozapine, Risperidone, Seroquel, Zyprexa.

[Remember: a giraffe can really see a zebra]

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These medications may have such intolerable side effects that the patient will stop the drugs.

One study showed the average time the meds were taken regularly was 3 months.

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Treatments

Psychotherapy - an adjunct to meds and is very useful to keep the patient on the meds.

Group therapy

Family therapy

Community support groups

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Early detection and treatment has the best results/response to treatment.

Per patients, once you have schizophrenia you have it for life. The best you can hope for is control.

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FYI: Cancer Study

A study in France in 1993, with 3470 patients with schizophrenia, showed that breast cancer was the second most common cause of death.