Schizophrenia (259.90

According to the DSM-V, there are several things necessary to make the diagnosis. There needs

to be a month-long period of time where at least one of the following are true: hallucinations,

delusions, or disorganized speech. There may also be disorganized behavior, such as catatonia.

The symptoms can be present for less than a month if they have been treated successfully. Six

months is the limit on time and there can’t be any affective symptomatology during that time.

Substance abuse or withdrawal cannot be a factor.

Good prognostic features include the onset of psychosis within 4 weeks of the first noticeable behavior change, good social or occupational function before symptom onset, and/or

symptoms accompanied by perplexity or confusion. If these are not present, it Is considered to

be “without good prognostic features.”

The disorder affects both males and females with equal prevalence but it occurs at a younger

age with males. It is not diagnosed as often as is schizophrenia in developed countries. The

incidence is higher in developing countries and is usually seen with good prognostic factors.

Schizophreniform disorder is often treated with antipsychotic drugs and sometimes by

antidepressant and antimanic drugs. Atypical antipsychotics are now preferred over typical

antipsychotic drugs. If these alone do not resolve the symptoms, then mood-stabilizers, SSRIs,

Lithium, or SNRI drugs are used. ECT (electroconvulsive therapy) has sometimes been found to

be effective.

SCHIZOPHRENIA (259.90)

The DSM-V classifies schizophrenia as being a psychotic thought disorder that lasts a minimum

of six months. While it appears in young adulthood, it is believed to be highly hereditary, with

patients having periods of relapse and remission throughout their lives. Most relapses come

from not taking the proper medicine. The newer antipsychotic drugs have fewer side effects

than the older drugs but patients still stop taking them because they think they no longer need

of them.

Schizophrenia is defined as having two or more symptoms listed here with one that must be

delusions, hallucinations, or disorganized speech. Other possible symptoms that can be present

include repetitive senseless movements, catatonia, apathy, flat affect, lack of motivation, lack

of energy, and failure to maintain adequate hygiene. This must affect occupational, personal

care, or social areas of the patient’s life with an inability to reach age-related functioning in

many life areas. Symptoms must last at least six months. Schizoaffective disorder, bipolar

disorder with psychotic features, and depression with psychotic features must be ruled out as

must psychosis secondary to ethanol withdrawal, cocaine abuse, or a medical condition.

There are several specifiers that can be used if the disease has been present for at least a year,

including the following:

A. First episode that is currently acute

B. First episode that is in partial remission

C. First episode that is in remission

D. Multiple episodes in an acute phase

E. Two or more episodes, currently in an acute phase

F. Multiple episodes, currently in remission

G. Multiple episodes in partial remission

H. Continuous symptoms

I. Unspecified with catatonia

J. Current severity from the five-point Likert scale (0-4, with four being the most

severe)

The onset of the disease is rare before adolescence or after 35 years of age. The peak age for

men is 20-25, while the peak age for women is older than 26 years. The onset can be insidious

or abrupt with about half of all patients having some depressive symptoms. The incidence is

about 1 percent of the population. Chemical dependency and tobacco use are common

comorbid conditions as is anxiety. There are many comorbid medical conditions that make

their lifespan shorter than average.