Disorder with essential features being presence of

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)
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AKrysiak || Schizophrenia || Spring 2020
CLINICAL PRESENTATION
ASSESSMENT PRIOR TO TREATMENT
PATHOPHYSIOLOGY
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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
