disorder with essential features being presence of characteristic psychotic

Disorder with essential features being presence of

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disorder with essential features being presence of characteristic psychotic symptoms during the active phase of the illness EPIDEMIOLOGY Onset of illness typically during adolescence or early adulthood and occurs equally in male and females o Peak onset for males – early 20s o Peak onset for females – late 20s, early 30s Prevalence ranges between 0.6 – 3%, depending on diagnostic criteria utilized Distributed uniformly worldwide Psychotic symptoms (non-schizophrenic) can occur at any time in life o Elderly at high risk due to deterioration of cortical areas of the brain (including dementias) and neurochemical changes o Comorbid physical illness, social isolation, sensory deficits and polypharmacy may also play a role ETIOLOGY No specific cause has been identified; however, many different theories postulated Neurodevelopment model o Perinatal insults – hypoxia, fetal distress, influenza, famine o Schizophrenic lesions – results in abnormalities in cell shape, position, symmetry, connectivity o Neuropsychological theories – young children that fail to meet normal motor milestones/abnormal movement later develop schizophrenia Genetics o 10% in first degree relatives; 3% among second degree relatives o 40% if both parents have the disease o 48% in monozygotic twins; 12-14% in dizygotic twins o Risk lies within the biological parent – adopted children still developed the disease even with altered environments o Newest research (2018): some mental disorders have overlapping gene expression Medications/Illicit substances o Anticholinergics o Cannabis o Dextromethorphan o Dopamine or dopamine agonists o Interferons o Stimulants (amphetamines) o Systemic steroids o Illicit substances: bath salts, cocaine (crack), lysergic acid diethylamide (LSD), methamphetamine, phencyclidine (PCP) 2
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AKrysiak || Schizophrenia || Spring 2020 CLINICAL PRESENTATION ASSESSMENT PRIOR TO TREATMENT PATHOPHYSIOLOGY 3 Diagnostic Criteria for Schizophrenia (DSM V): delusions, hallucinations or disorganized speech must be present A. Characteristic Symptoms: Two or more of the following , each persisting for a significant portion of at least a 1 month period and must have at least 1 of the * symptoms: 1. Delusions* 2. Hallucinations* 3. Disorganized Speech* 4. Grossly disorganized or catatonic behavior 5. Negative symptoms B. Social/occupational dysfunction: For a significant portion of the time since onset of the disorder, one or more major areas of functioning such as work, interpersonal relations, or self-care are significantly below the level prior to onset. C. Duration: Continuous signs of the disorder for at least 6 months . This must include at least 1 month of symptoms fulfilling Criterion A (unless successfully treated). These 6 months may include prodromal or residual symptoms. D. Schizoaffective or mood disorder has been excluded. E. Disorder is not due to a medical disorder or substance abuse. F. If a history of a pervasive developmental disorder is present, there must be symptoms of hallucinations or delusions present for at least 1 month. ____________________ Symptoms
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