Mental Health Book

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Schizophrenia

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  1. See Also
    1. Psychosis
  2. Epidemiology
    1. Prevalence: 1% across all ethnicity, nationality
    2. Gender: Equal among men and women
      1. Men present in teen and early 20s
      2. Women present in their 20s and 30s
  3. Pathophysiology
    1. Polygenic condition (expression impacted by environ.)
    2. Protective factors in the family environment
      1. Uncommon criticism
      2. Straightforward communication
    3. Neurotransmitter Dopamine
      1. Increased Dopamine exacerbates positive symptoms
      2. Antipsychotics are primarily reduce Dopamine
  4. Risk Factors
    1. Family History (most significant risk)
      1. Monozygotic twin: 50% lifetime Incidence
      2. Dizygotic twin: 17% lifetime Incidence
      3. First degree relative: 6-17% lifetime Incidence
      4. Lewis (2000) Neuron 28:325
    2. Other risks (insufficient evidence)
      1. Socioeconomic factors
      2. Maternal infections
  5. Types
    1. See Psychosis Types
  6. Symptoms
    1. See Psychosis Symptoms
    2. Often preceded by prodromal phase
      1. Social withdrawal
      2. Loss of interest in school or work
      3. Hygiene and grooming deteriorate
      4. Angry outbursts
      5. Unusual behavior
  7. Signs
    1. See Psychosis Exam
  8. Labs
    1. See Psychosis Labs
  9. Differential Diagnosis
    1. See Psychosis Differential Diagnosis
  10. Diagnosis
    1. Schizophrenia Diagnosis
  11. Management
    1. See Neuroleptic Medications
    2. Pitfalls
      1. Atypical Antipsychotics offer no significant benefit
        1. Consider low dose first generation agents instead
      2. Patients stop their medications frequently
        1. Patients who stopped meds within 18 months: 74%
        2. Lieberman (2005) New Engl J Med 353:1209
      3. Delay in treatment significantly worsens prognosis
        1. Wyatt (1997) Psychol Med 27:261
  12. Prognosis
    1. High risk of Suicide (10% lifetime risk)
  13. References
    1. (2000) DSM IV, APA, p. 297-343
    2. Freedman (2003) N Engl J Med 349:1738
    3. Lewis (2000) Neuron 28:325
    4. Schultz (2007) Am Fam Physician 75:1821

Schizophrenia (C0036341)

Definition (MSH)A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, hallucinations, emotional disharmony, and regressive behavior.
Definition (CSP)class of psychoses with disturbance mainly of cognition (content and form of thought, perception, sense of self versus external world, volition) and psychomotor function, rather than affect.
ConceptsMental or Behavioral Dysfunction (T048)
ICD9295, 295.9, 295.90
DanishSkizofreni alle typer
DutchSchizofrenie alle vormen
EnglishDementia Praecox, Schizophrenia, Schizophrenia all types, Schizophrenias, SCHIZOPHRENIC DIS, Schizophrenic Disorder, Schizophrenic Disorders, SCZD, Unspecified schizophrenia
FinnishSKITSOFRENIAN KAIKKI MUODOT
FrenchSchizophrenie tous types
Hebrewsxizofrenia
Hungarianschizophrenia minden faja
ItalianSchizofrenia tutti i tipi
NorwegianSCHIZOFRENI ALLE TYPER
PortugueseEsquizofrenia todos os tipos
Spanishesquizofrenia, esquizofrenia no especificada, trastornos esquizofrénicos, trastornos esquizofrenicos
SwedishSKIZOFRENI ALLA TYPER
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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