Schizophrenia Disorders III

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Overview – Schizophrenia Disorders, Part 3     

Schizophrenia or dementia praecox as it was once known, has been considered a unique psychotic mental illness for over a century. It is characterized by behavioral, emotional, and cognitive or thinking disturbances such as delusions and hallucinations—associated with impaired personal, occupational, social, and selfcare functioning. The disorder can last a lifetime. It appears that there are interactions of several genes with environmental risk factors, some of which may begin during gestation. 

Prevalence estimates of Schizophrenia and the multiple subtypes that form the Schizophrenia Spectrum range between 0.25 and 1.00 percent in the general population. 

In Schizophrenia Disorders, Part 1 (Module 14), information on four types of disorders was presented, one type each day for four days:

  1. Schizophrenia Disorder
  2. Schizoaffective Bipolar Disorder
  3. Schizoaffective Depressive Type Disorder
  4. Schizophrenia Substance Induced Disorder

In Schizophrenia Disorders, Part 2 (Module 15), information on four additional types of disorders was presented, one type each day for four days:

  1. Schizotypal Disorder
  2. Delusional Disorder
  3. Brief Psychotic Disorder
  4. Schizophreniform Disorder

Schizophrenia Disorders, Part 3 (Module 16), presents Information on four more types of disorders, one type each day for four days. These are:  

Schizophrenia Due to Medical Condition

Schizophrenia due to a Medical Condition is mental illness associated with a primary medical condition. It is characterized by a range of cognitive, behavioral, and emotional dysfunctions that align with Schizophrenia and symptoms that align with the Medical Condition. It can be very complicated to diagnose as the medical condition may exacerbate the associated Schizophrenia and vice versa. In addition, there may be some underlying condition such as an autoimmune disease that is impacting one or both of the conditions: Schizophrenia and the medical condition. It may even go unrecognized.

A diagnosis may be made when at least three out of twelve symptoms are present:  

  • Stupor. An oblivious inability to move or respond to stimuli.
  • Catalepsy. A rigid body posture.
  • Mutism. Little or no verbal communication.
  • Waxy flexibility. Body remains in whatever position it is placed by another person.
  • Automatic obedience.
  • Negativism. A lack of verbal response.
  • Posturing. Maintaining a posture or position that goes against gravity.
  • Mannerisms. Extreme or odd movements.
  • Stereotypy. Frequent repetitive movements or agitation for no reason.
  • Grimacing. Distorted facial expressions.
  • Echolalia. Repeating others’ words.
  • Echopraxia. Repeating others’ movements.
Catatonia Due to Mental Condition

Catatonia is a neuropsychiatric disorder that affects behavioral and motor functions and has been linked with a variety of mental illnesses including Schizophrenia and Mood Disorders. It is characterized by the absence of evidence of a general medical condition that is etiologically related to the catatonia and by the presence of other symptoms characteristic of Schizophrenia (e.g., delusions, hallucinations, disorganized speech, negative symptoms). 

Catatonia has been linked with a variety of mental illnesses including:

  • Schizophrenia
  • Mood disorders
  • Encephalitis
  • Neurodevelopmental Disorders
  • Bipolar Disorder
  • Depressive Disorders
  • Psychotic Disorders 
Catatonia Due to Medical Condition

Catatonia due to a medical condition is a neuropsychiatric disorder that affects behavioral and motor functions. Unfortunately, it is often unrecognized. Although often associated with schizophrenia and other affective disorders, catatonia may be a result of, or due to, any number of medical conditions. 

The clinician may make this diagnosis if there is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct physiological consequence of a general medical condition; the disturbance is not better accounted for by another mental disorder, and the disturbance does not occur exclusively during the course of a delirium. The precise cause of catatonia due to a medical condition is not completely understood.

Unspecified Schizophrenia

Unspecified Schizophrenia Disorder may be assigned as a diagnosis when individuals are experiencing symptoms of schizophrenia or other psychotic disorders but do not meet the full diagnostic criteria for schizophrenia or another more specific psychotic disorder. This diagnosis can be assigned when the clinician decides not to specify the reason the diagnostic criteria are unmet, or if there is insufficient information available at the time of the evaluation to make a more specific diagnosis. 

The symptoms cause distress and impair functioning in social, occupational, or other major areas of life. Individuals will have difficulty functioning and completing required tasks of daily living. However, the symptoms are not present in sufficient quantity or severity for a diagnosis of Schizophrenia. Nevertheless, they are too enduring for a diagnosis of Brief Psychotic Disorder 

Malingering for secondary gains needs to be explored. An expansion of the criteria for pathology, or a vague definition of pathology, can create more opportunity for malingering. A malingering patient may use this as an opportunity to minimize criminal culpability or to avoid general adult life responsibilities by seeking disability benefits for a condition that does not exist. 

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