Symptoms
Catatonic type:
Paranoid type:
- Delusional thoughts of persecution or of a
grandiose nature
- Anxiety
- Anger
- Violence
- Argumentativeness
Disorganized type:
- Incoherence (not understandable)
- Regressive behavior
- Flat affect
- Delusions
- Hallucinations
- Inappropriate laughter
- Repetitive mannerisms
- Social withdrawal
Undifferentiated type: Patient may have symptoms of more than one subtype of schizophrenia
.
Residual type: Prominent symptoms of the illness have abated, but some features - such as hallucinations
and flat affect - may remain.
Exams and Tests
Because other diseases can also cause symptoms of psychosis
, psychiatrists should make the final diagnosis. The diagnosis is made based on a thorough psychiatric interview
of the person and family members. As yet, there are no defining medical tests for schizophrenia
. The following factors may suggest a schizophrenia diagnosis, but do not confirm it:
- Developmental background
- Genetic and family history
- Changes from level of functioning prior to illness
- Course of illness and duration of symptoms
- Response to pharmacological therapy
CT scans of the head
and other imaging techniques may identify some changes associated with schizophrenia in the research literature and may rule out other neurophysiological disorders.
Treatment
During an acute
episode of schizophrenia, hospitalization is often required to promote safety, and to provide for the person's basic needs such as food, rest, and hygiene
.
Antipsychotic or neuroleptic medications work by changing the balances of chemicals in the brain
and are used to control the symptoms of the illness. These medications are effective, but are also associated with side effects that may discourage a
patient from taking them regularly. However, many of these side effects can be addressed, and should not prevent people from seeking treatment for this serious condition.
Common side effects from traditional antipsychotics may include sedation
and weight gain. Other side effects are known as extrapyramidal symptoms (muscle contractions, problems of movement and gait, and feelings of restlessness
or "jitters").
Long-term risks include a movement disorder called tardive dyskinesia
, which involves involuntary movements. Newer agents known as atypical antipsychotics, appear to have a somewhat safer regarding side effects. They also appear to help people who have not benefited from the older traditional medications. Ongoing treatment with medications is usually necessary to prevent a
return of symptoms.
Supportive and problem-focused forms of psychotherapy may be helpful for many individuals. Behavioral techniques, such as social skills training, can be used in a
therapeutic setting, or in the patient's natural environment to promote social and occupational functioning.
Family interventions that combine support and education about schizophrenia
(psychoeducation) appear to help families cope and reduce relapse. Patients who lack family and social support may be helped by intensive case management
programs that emphasize active outreach and linkage to a range of community support services.
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