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Home / Schizophrenia

SCHIZOPHRENIA

Schizophrenia is a serious mental disorder that generally starts in late adolescence or early adulthood. This illness effects nearly 1 in 100 persons in their lifetime. It is a chronic brain disorder varying in presentation, symptoms severity and course. However with

Symptoms

Symptoms clusters found in schizophrenia include:

(a)  thought disorders

(b)  delusions of control, influence, or passivity

(c)   hallucinatory voices giving a running commentary on the patient’s behaviour, or discussing the patient among themselves, or other types of hallucinatory voices coming from some part of the body;

(d)   persistent delusions of other kinds that are culturally inappropriate and completely

impossible

(e)   persistent hallucinations in any modality, when accompanied either by fleeting or half-formed delusions

(f)   breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech, or neologisms

(g)  catatonic behaviour, such as excitement, posturing, or waxy flexibility, negativism, mutism, and stupor;

(h)  “negative” symptoms such as marked apathy, paucity of speech, and blunt emotional responses, usually resulting in social withdrawal and lowering of social performance

(i)   a significant and consistent change in the overall quality of some aspects of personal behaviour,    manifest as loss of interest, aimlessness, idleness, a self-absorbed attitude, and social withdrawal.

Diagnosis

There is no simple test to diagnose Schzophrenia. Diagnosis of Schizophrenia is based on careful clinical evaluation to rule out other medical neurological conditions, substance intoxication/ withdrawal, tests and screenings, mental status evaluation and diagnostic psychiatric evaluation, and fulfilment of diagnostic criteria as laid out in ICD 10 and DSM 5. The psychiatric evaluation includes clinical history, mental status examination, family/personal/substance abuse history and diagnostic psychiatry rating scales.

Course and Outcome of Schizophrenia in women

  • Prevalence of schizophrenia is same in both men and women but the disease onset is later in women.
  • Studies have shown that women have a better outcome than men over short term.
  • Women seem to have more affective and paranoid symptoms, lesser negative symptoms.
  • Neuro endocrine side effects of anti psychotic medication specially secondary to raised prolactin levels can cause significant distress in female patients.
  • Obesity and weight gain is also commoner among women and has specific psychological effects.
  • The misconception that marriage cures mental illness is widely prevalent. In developing countries like India where marriages may be arranged by family, patients with diagnosis of schizophrenia get married but face difficulties in sustaining relationship. Greater numbers of separation and divorces are seen in women with schizophrenia than men with this disease.
  • In married women the decision of child birth and medications during pregnancy are of important concern. The pregnancy outcomes in women with schizophrenia suggest increased incidence of intrauterine growth retardation, premature birth.
  • Homelessness is a most visible social sequelae of psychosis in women. Stigma and burden felt by the caregivers is higher if the patient is a woman.

Other types of Psychosis

Apart from Schizophrenia other conditions with psychosis include Schizoaffective disorder, Schizotypal/ Schizoid personality disorders, Delusional disorder, Brief and Transient psychotic disorder. Psychosis symptoms and presentation may be a part of many other psychiatric illnesses and medical disorders. The prognosis, treatment modality and response varies with the diagnosis.


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