Schizophrenia: A short summary

Historical Background: in 1896, Emil Kraepelin differentiated psychiatric illness into 2 major groups.

• Dementia Precox
• Mani depressive illness( psychosis)

Eugen Bleuer's Fundamental Symptoms of Schizophremi: Ambivalence Autism Affective Flattening Association disorder

First Rank symptoms
I. Hallucinations
1. Audible thoughts/thought echo 2. Voices heard arguing 3. Voices giving running commentary II. Thought Alienation Phenomenon a) Thought withdrawal b) Thought insertion c) Thought broadcasting
III. Passivity Phenomenon A. Made feelings B. Made volition C. Made impulses IV. Delusional Perception

Epidemiology; Point prevalence of Schizophrenia is 0.5 to 1 %. The Incidence is about 0.5 in 1000 persons

Clinical features Thought and speech Disorders Autistic thinking, loosening of association, thought blocking, neologism, paraphasias, mutism, perseveration, verbigeration Delusions: primary and secondary Disorders Of Perception Hallucinations Disorders of Affect Disorders of Motor Behaviour Negative Symptoms Suicidal Tendency

Clinical types: Simple Schizophrenia Hebephrenic Schizophrenia Catatonic Schizophrenia Residual Schicophrenia Undifferentiated Schizophrenia Post-schizophrenic depression Others

Bad Prognostic Factors Male Negative Symptoms Early Onset Insidious progression Chronic Course

Diagnostic Criteria: According to DSM IV TR 2 or more of the following is required with 6 months of duration of disease with at least 1 month of Active symptoms 1. Delusion Hallucinations Bizzare Behaviour Bizzare thoughts

MANAGEMENT: 1. Pharmacological Treatment: Generally the treatment is continued for 6 months to 1 year for the first episode, for 1-2 year for subsequent episodes. Fluphenazine 25-30 mg IM every 2-3 weeks Penfluridol Flupenthixol Haloperidol ECT ( Electroconvulsive Therapy) Miscellaneous Treatments Limbic Leucotomy Psychosocial Treatment.