presenting to the emergency room with

Auditory Hallucination
F.L., a 20 year old man and
Paranoid Delusion
can be diagnosed as

Schizophrenia Brief Psychotic Disorder Schizophreniform Disorder Schizoaffective Disorder Delusional Disorder
which has which has which has which has
which has

EPIDEMIOLOGY EPIDEMIOLOGY EPIDEMIOLOGY EPIDEMIOLOGY EPIDEMIOLOGY

- 1% lifetime prevalence - generally considered uncommon - 0.11% lifetime prevalence - 0.5-0.8% lifetime prevalence - 0.2-0.3% US prevalence
- equal prevalence in both sexes - occurs more often in 20-30 y.o - most common in adolescents & young adults - equal prevalence in both sexes - range age of onset: 18-90 y.o
- Peak age of onset: - more common in women - less than half as common as schizophrenia - bipolar subtype: equal (mean: 40 y.o)
> 10-25 y.o in men - depressed subtype: 2x greater in females - Slightly greater in females
> 25-35 y.o in women caused by caused by
caused by caused by
caused by
ETIOLOGY ETIOLOGY
- unknown - not known ETIOLOGY ETIOLOGY
ETIOLOGY - Possibly due to biological or - Possibly due to enlarged - Unknown - Unknown
- Genetic factors psychological vulnerability cerebral ventricles - Possibly due to - Possibly due to biologic factors
- Biochemical factors disrupted DISC1 gene & psychodynamic factors
Identified by Identified by
- Neuropathology Identified by
Identified by
Identified by
DIAGNOSIS DIAGNOSIS & CLINICAL FEATURES
- Acute psychotic disorder that has a rapid DIAGNOSIS & CLINICAL FEATURES
- psychotic symptoms that last at least 1 DIAGNOSIS & CLINICAL FEATURES
DIAGNOSIS onset and lack long prodromal phase - DSM-5 diagnostic criteria: meets the
day but less than 1 month and are not - DSM-5 diagnostic criteria
- at least 2 symptoms listed in criterion - Initial symptom profile is same as that of criteria of manic or depressive episode
associated with mood disorder, - Mental status exam
A of DSM-5 diagnostic criteria (e.g schizophrenia in that 2 or more psychotic - Mood component is present for the
substance related, or psychotic disorder *Diagnosis is made when a person exhibits
delusions & hallucinations) symptoms must be present majority of total illness
caused by a general medical condition nonbizzare delusions of atleast 1 month’s
- Impaired functioning during the - Return to baseline state within 6 months with duration that cannot be attributed to other
active phase of illness manifesting psychiatric disorders*
- persists for at least 6 months with
with
manifesting COURSE & PROGNOSIS
CLINICAL FEATURES
- affective: better prognosis
- at least one major symptom of psychosis COURSE & PROGNOSIS - schizophrenic: worse prognosis
CLINICAL FEATURES (e.g hallucinations, delusions, and - Lasts more than 1 month and less COURSE & PROGNOSIS
- Premorbid sx: quiet, passive, & introverted disorganized thoughts) than 6 months managed by
- Psychosocial stressors often accompanies
- Prodromal sx: somatic symptoms, peculiar - characteristic symptoms: emotional - 60-80% progress to schizophrenia the onset of delusional disorder
behavior, abnormal affect, unusual speech, volatility, strange or bizarre behavior, - Onset is sudden
bizarre ideas, & strange perceptual experiences screaming or muteness, and impaired managed by TREATMENT & MANAGEMENT - 50% recover at long term follow up
memory of recent events - Mood stabilizers - 20% decreased symptoms
with - Antidepressants - 30% exhibit no change
with TREATMENT & MANAGEMENT
- Hospitalization - Psychosocial treatment
managed by
COURSE & PROGNOSIS - Antipsychotic treatment
- Symptoms begin in adolescence and followed by COURSE & PROGNOSIS - Psychotherapy
prodromal symptoms in days to a few months - lasts less than 1 month TREATMENT & MANAGEMENT
- Deterioration of patient’s functioning follows - 50% later display chronic psychiatric syndromes - Psychotherapy
each relapse of psychosis - generally good prognosis - Hospitalization
- 10-20% patients have good outcome - Suicide is a concern during psychotic phase - Pharmacotherapy
- >50% patients have poor outcome
managed by
- Remission rates 10-60% B1M5C1: “Increasingly Odd”
Level 3 Group 18
managed by
TREATMENT & MANAGEMENT Facilitator: Dr. Lorliwyn Pollescas
- Hospitalization Leader: Diola, Ma. Duannie Trisha
TREATMENT & MANAGEMENT - Pharmacotherapy Secretary: Girasol, Peter Paul
- Hospitalization - Psychotherapy Members:
- Pharmacotherapy (e.g Chlorpromazine & Clozapine) Albios, Efren Ezekiel
- Psychosocial therapies Balingasa, Erwin Christian
*Greater benefits from combined antipsychotic drugs Blantucas, Raiz Shanetel
and psychosocial treatment* Cericos, Katelyn
Clerigo, Christian Jay
Hinay, Kirstyl Chariz