SCHIZOPHRENIA SPECTRUM

AND OTHER PSYCHOTIC

DISORDERS
PGMI ABADILLA ANGELA MARIE
SCHIZOPHRENIA
 comprises a group of  one of the most common
disorders with of the severe mental
heterogeneous etiologies disorders
 sometimes referred to as a  schizophrenia is one of the
syndrome, as a group of top 25 leading causes of
disorders, or, as in the fifth disability
edition of the Diagnostic  low prevalence
and Statistical Manual of
Mental Disorders (DSM-5),
the schizophrenia
spectrum disorders
EPIDEMIOLOGY
INCIDENCE AND
PREVALENCE GENDER AND AGE
Lifetime prevalence of equally prevalent in men
schizophrenia – 1% and women
0.05% of total Onset: early in men
population – treated for More than half of all male
schizophrenia in 1 yr schizophrenia patients,
Only half of all the only one-third of all
patients obtain female schizophrenia
treatment patients - first admitted
to a psychiatric hospital
before age 25 years
GENDER AND AGE
Peak age of onset: Rare: before age 10 and
10 to 25 years for men after 60 years
25 to 35 years for women Late onset: after age 45
3-10% women – disease
onset after age 40
90% of patients in
treatment for
schizophrenia are between
15 and 55 years old
Reproductive Factors Medical Illness
First degree biological Persons with schizophrenia
have a higher mortality rate
relatives of persons with
from accidents and natural
schizophrenia have a ten causes than the general
times greater risk for population
developing the disease Several studies have shown
than the general that up to 80 percent of all
population. schizophrenia patients have
significant concurrent medical
illnesses and that up to 50
percent of these conditions
may be undiagnosed.
Infection and Birth
Season Substance Abuse
more likely to have been Substance abuse is
born in the winter and common in
early spring schizophrenia
studies show that the lifetime prevalence of
frequency of any drug abuse - >50%
schizophrenia is increased lifetime prevalence of
after exposure to
alcohol – 40%
influenza – winter, during
2nd trimester of pregnancy
 Socioeconomic and Cultural
RACE AND RELIGION Factors
Jews are affected less begins early in life;
often than Protestants causes significant and long-
and Catholics, and lasting impairments
prevalence is higher in makes heavy demands for
non-white populations. hospital care; and requires
ongoing clinical care,
rehabilitation, and support
services, the financial cost
of the illness is estimated
to exceed
THE CLINICAL PRESENTATION
No clinical sign or The appearance of a
symptom is patient with
pathognomonic for schizophrenia can range
schizophrenia from that of a completely
every sign or symptom disheveled, screaming,
seen in schizophrenia agitated person to an
occurs in other obsessively groomed,
psychiatric and completely silent, and
neurologic disorders immobile person.
poorly groomed, fail to Other odd behaviors
bathe, and dress too include tics, stereotypies,
warmly for the prevailing mannerisms, and,
temperatures. occasionally, echopraxia,
in which patients imitate
the posture or the
behavior of the
examiner.
 Localizing and  Neurologic signs and
nonlocalizing neurologic symptoms correlates with
signs are more common in increased severity of
patients with illness, affective blunting,
schizophrenia than in and a poor prognosis.
other psychiatric patients  Abnormal neurologic signs
 Nonlocalizing signs
include tics, stereotypies,
include grimacing, impaired fine
dysdiadochokinesia, motor skills, abnormal
astereognosis, primitive motor tone, and abnormal
reflexes, and diminished movements
dexterity.  schizophrenia have an
elevated blink rate
DIAGNOSIS

based on observation and

description of the patient
Abnormalities are often
present on most
components of the mental
status examination.
No pathognomonic signs
or symptoms.
OBJECTIVE TESTS FOR THE DISORDER
Diagnostic and Rating Scales for
Schizophrenia
Positive and Negative
Syndrome Scale (PANSS)
most widely used
measure of symptom
severity in schizophrenia
30-item scale
TYPES
Subtypes from Previous
Catatonic Type Versions of DSM
The classic feature of the Previous versions of the
catatonic type is a DSM described subtypes
marked disturbance in of schizophrenia based
motor function; this predominantly on the
disturbance may involve clinical features.
These were: paranoid,
stupor, negativism,
rigidity, excitement, or disorganized, catatonic,
posturing. undifferentiated, and
residual subtype. DSM-5
no longer includes these.
 TREATMENT
antipsychotic
medications are the
mainstay of the
treatment for
schizophrenia
Psychosocial
intervention
TREATMENT
ANTIPSYCHOTIC
first-generation Typical antipsychotics,
dopamine receptor or dopamine receptor
antagonists and the antagonists
second-generation High-potency agents are
agents such as more likely to cause
serotonin–dopamine extrapyramidal side
antagonists such as effects such as akathisia,
risperidone and acute dystonia, and
clozapine. pseudoparkinsonism
Schizophreniform disorder
By definition, patients
with schizophreniform
disorder have the
symptoms for at least a
month and return to
their baseline state
within 6 months
Better prognosis
TREATMENT FOR
SCHIZOPHRENIFORM
Recurrent episode – give
prophylaxis
Psychotic symptoms can
usually be treated by 3-6
months of antipsychotic
drugs
Psychotherapy
Brief psychotic disorder
psychotic condition that
involves the sudden
onset of psychotic
symptoms
lasts 1 day or more but
less than 1 month
Brief psychotic disorder
is an acute and transient
psychotic syndrome.
Schizoaffective disorder
Mood symptoms develop Better prognosis than
concurrently with Schizophrenia and worse
symptoms of than mood disorder
schizophrenia, but
delusions or
hallucinations must be
present for 2 weeks in
the absence of
prominent mood
symptoms during some
phase of the illness.
TREATMENT FOR SCHIZOAFFECTIVE
DISORDER
Mood stabilizers are a Maintenance: dosage can
mainstay of treatment be reduced to a low to
for bipolar disorders and middle range to avoid
schizoaffective disorder adverse effects and
carbamazepine was potential effects on organ
superior for systems
schizoaffective disorder
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