 |
 |
|||||||||||||||||||||||
  SchizophreniaSchizophrenia American Description (How Diagnosis Is Made In America) Diagnostic Criteria Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated): delusions hallucinations disorganized speech (e.g., frequent derailment or incoherence) grossly disorganized or catatonic behavior negative symptoms, i.e., affective flattening, alogia, or avolition Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other. Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement). Duration: Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). Schizoaffective and Mood Disorder exclusion: Schizoaffective Disorder and Mood Disorder With Psychotic Features have been ruled out because either (1) no Major Depressive, Manic, or Mixed Episodes have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods. Substance/general medical condition exclusion: The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. Relationship to a Pervasive Developmental Disorder: If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated). Diagnostic Criteria of Schizophrenia Subtypes (What Physcians Look For) *Paranoid Type A type of Schizophrenia in which the following criteria are met: Preoccupation with one or more delusions or frequent auditory hallucinations. None of the following is prominent: disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect. * Catatonic Type A type of Schizophrenia in which the clinical picture is dominated by at least two of the following: motoric immobility as evidenced by catalepsy (including waxy flexibility) or stupor excessive motor activity (that is apparently purposeless and not influenced by external stimuli) extreme negativism (an apparently motiveless resistance to all instructions or maintenance of a rigid posture against attempts to be moved) or mutism peculiarities of voluntary movement as evidenced by posturing (voluntary assumption of inappropriate or bizarre postures), stereotyped movements, prominent mannerisms, or prominent grimacing echolalia or echopraxia * Disorganized Type A type of Schizophrenia in which the following criteria are met: All of the following are prominent: disorganized speech disorganized behavior flat or inappropriate affect The criteria are not met for Catatonic Type. *Undifferentiated Type A type of Schizophrenia in which symptoms that meet Criterion A are present, but the criteria are not met for the Paranoid, Disorganized, or Catatonic Type. * Residual Type A type of Schizophrenia in which the following criteria are met: Absence of prominent delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior. There is continuing evidence of the disturbance, as indicated by the presence of negative symptoms or two or more symptoms listed in Criterion A for Schizophrenia, present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). information obtained from the following web site Internet Mental Health (www.mentalhealth.com) copyright © 1995-2001 by Phillip W. Long, M.D What Is Schizophrenia? Schizophrenia, a disease of the brain, is one of the most disabling and emotionally devastating illnesses known to man. But because it has been misunderstood for so long, it has received relatively little attention and its victims have been undeservingly stigmatized. Schizophrenia is not a split personality, a rare and very different disorder. Like cancer and diabetes, schizophrenia has a biological basis; it is not caused by bad parenting or personal weakness. Schizophrenia is, in fact, a relatively common disease, with an estimated one percent to one and a half percent of the U.S. population being diagnosed with it over the course of their lives. While there is no known cure for schizophrenia, it is a very treatable disease. Most of those afflicted by schizophrenia respond to drug therapy, and many are able to lead productive and fulfilling lives. What are its symptoms? Schizophrenia is characterized by a constellation of distinctive and predictable symptoms. The symptoms that are most commonly associated with the disease are called positive symptoms, that denote the presence of grossly abnormal behavior. These include thought disorder, delusions, and hallucinations. Thought disorder is the diminished ability to think clearly and logically. Often it is manifested by disconnected and nonsensical language that renders the person with schizophrenia incapable of participating in conversation, contributing to his alienation from his family, friends, and society. Delusions are common among individuals with schizophrenia. An affected person may believe that he is being conspired against (called "paranoid delusion"). "Broadcasting" describes a type of delusion in which the individual with this illness believes that his thoughts can be heard by others. Hallucinations can be heard, seen, or even felt; most often they take the form of voices heard only by the afflicted person. Such voices may describe the person's actions, warn him of danger or tell him what to do. At times the individual may hear several voices carrying on a conversation. Less obvious than the "positive symptoms" but equally serious are the deficit or negative symptoms that represent the absence of normal behavior. These include flat or blunted affect (i.e. lack of emotional expression), apathy, and social withdrawal). Who gets it? While schizophrenia can affect anyone at any point in life, it is somewhat more common in those persons who are genetically predisposed to the disease. The first psychotic episode generally occurs in late adolescence or early adulthood. * Genetic Link -- The probability of developing schizophrenia as the offspring of two parents, neither of whom has the disease, is 1 percent. -- The probability of developing schizophrenia as the offspring of one parent with the disease is approximately 13 percent. -- The probability of developing schizophrenia as the offspring of both parents with the disease is approximately 35 percent. * Onset by Age -- Three-quarters of persons with schizophrenia develop the disease between 16 and 25 years of age. -- Onset is uncommon after age 30, and rare after age 40. * Onset by Sex -- In the 16-25 year old age group, schizophrenia affects more men than women. -- In the 25-30 year old group, the incidence is higher in women than in men. What is the course of the disease? Studies have shown that some persons with schizophrenia recover completely, and many others improve to the point where they can live independently, often with the maintenance of drug therapy. Fortunately, this accounts for the majority of cases. However, approximately 15 percent of people with schizophrenia respond only moderately to medication and require extensive support throughout their lives, while another 15 percent simply do not respond to existing treatment. New therapies may offer hope for the treatment of these most seriously affected sufferers. How is it treated? Hospitalization is often necessary in cases of acute schizophrenia. This ensures the safety of the affected person, while allowing for observation by trained mental health professionals to determine whether schizophrenia is the appropriate diagnosis. Hospitalization also allows for the initiation of medication under close supervision. Antipsychotic drugs (also called neuroleptics), available since the 1950s, can dramatically improve the functioning of people with schizophrenia. Once the most troubling symptoms are controlled by medication, the person often does not require hospitalization. Depending on the seriousness of the disease, the person may utilize day programs, rehabilitation facilities, and be treated in an outpatient setting. This allows the psychiatrist to adjust medication dosages as necessary over the course of the disease. The person may also need assistance in readjusting to society once his or her symptoms are controlled. Supportive counseling or psychotherapy may be appropriate for these individuals as a source of friendship, encouragement, and practical advice during this process. Relatives and friends can also assist in rebuilding the person's social skills. Such support is very important. What can/should I do if a loved one is sick? Because an individual with schizophrenia may not be aware that he is ill, it is often necessary for a friend or relative to make certain that proper treatment is sought. A good doctor is critical; it helps to find one through the recommendation of other families or healthcare professionals . Once the person is released from the hospital, families are often left with the responsibility of ensuring that the person is taking medication and is continuing to receive whatever other treatment is necessary. The best way to treat a friend or relative with schizophrenia is with compassion, understanding, and support. The person should not be made to feel as if the disease is his or anybody's fault. As Dr. E. Fuller Torrey has stated, "People do not cause schizophrenia; they merely blame each other for doing so." Learning about the disease and its treatment will help to avoid the temptation to blame. In addition to seeking help for the person afflicted with the disease, loved ones often find mutual support to be invaluable. AMI/FAMI is a grassroots, self-help organization of families and friends of people with serious mental illnesses. Members meet regularly to share practical information and common experiences. Medications Today, antipsychotic medications are frequently prescribed to people with schizophrenia to alleviate symptoms. Each medication has its own set of advantages and drawbacks. Your doctor will prescribe a medication based on your unique set of symptoms and medical history. Recently, a new class of drugs known as serotonin-dopamine antagonists has been found to effectively treat the symptoms of schizophrenia for some patients better than previous medications. Unlike other antipsychotic medications, this type of drug blocks both dopamine and serotonin transmissions. Clozaril, Risperdal, Zyprexa, and Seroquel are four newer antipsychotic medications which have effectively treated both the positive and negative symptoms of schizophrenia. Many people with schizophrenia find that their symptoms are alleviated with older antipsychotic medications, which are divided into groups depending on their potency. Potency is a measure of how much of the drug is needed to effectively treat the symptoms of schizophrenia. If a drug is low potency, more of it is needed to relieve the symptoms of schizophrenia. A high potency drug can be taken in a smaller amount to be effective. Medium potency drugs are effective in relieving the symptoms of schizophrenia when a medium-sized dose is taken.
Resources National Alliance for the Mentally Ill 200 North Glebe Road, Suite 1015 Arlington, Virginia 22203-3754 Toll Free Helpline-1-800-950-NAMI (6264) Front Desk-(703)524-7600 website: http://www.nami.org National Institute of Mental Health 6001 Executive Boulevard Rm. 8184 MSC 9663 Bethesda, MD 20892-9663 website: http://www.nimh.nih.gov National Mental Health Association 1021 Prince St. Alexandria, VA 22314 1-800-969-6642 phone number: (203)878-5669 website: http://www.nmha.org/ Links Mental Health Web Site Schizophrenia Web Site Schizophrenia: Questions And Answers Schizophrenia Newsletter 
 
 
 
Midi is Moonlight Pond used with permission David Folsom to adjust midi please right click here |
