this is my first Presentation which I have Uploaded on this site..do make the use of it for up gradation of your knowledge

1. Mr. Aaron S. Gogate-Basic

2. INTRODUCTION
A Greek word splited as:
SKCHIZO-To Divide
PHREN-Mind
Termed by kraplein in 1896 as ‘Demensia
Precox’
In 1908 Eugene bleuler coined it as
Schizophrenia

3. It is a psychotic condition characterized by
a disturbance in thinking, emotions,
volitions and faculties in the presence of
clear consciousness, which usually leads
to social withdrawal
It is a type of functional psychosis
characterized mainly by disturbance in
thinking and associated disturbances in
psychomotor activity, affect, perception
and behavior.

4. ETIOLOGY
1) IDOPATHIC
2) HEREDITARY:-
-Incidence high in univolvar twins
-Transmission through one or more
autosomal recessive genes
3) PERSONALITY-SCHIZOID
4) CHILD DEVELOPMENT AND PARENT CHILD
RELATIONSHIP
5) AGE-Peak in between 15-30 and also some
after30 yrs

5. 6) SEX-Equal in both sexes
7) SOCIAL ISOLATION-Predisposed unstable
personal relationship
8) INTELLIGENCE
9) OVERCROWDING SLUMS
10) PRECIPITATION-Stress, regarding ineffective
disease, pregnancy, family problem, etc.
11) ENDOCRINE-Excess of dopamine dependent
neuronal activity in brain
12) ASSOCIATED WITH OTHER DISEASES-
More common in temporal lobe epilepsy

7. a) Autistic thinking-important feature
b) Considers two things identical
c) Disturbed thinking, emotions and behavior.
d) Patient appears absurd and bizarre
e) Social withdrawal from
religion, philosophy, science, sex, and power

8. g) Absence of links between ideas, crowding and
poverty of ideas, flight of ideas
h) Word are linked without meaning(word salad)
a. Emotional blunting or shallowness of affect
b. Inappropriate affect-patient laughs when he is
expected to cry and cries when he is expected
to laughs
c. Hypersentiveness or insensitiveness of feelings
d. Ambivalence-experience of 2 opposite of
feelings

9. a) Irrelevant and inappropriate behavior
b) Awkward actions
c) Rowdy, violent, assaultive(a person has a physical
or verbal violence), agitation
d) Suicidal and homicidal tendencies
e) Criminal and sexual over activity, pervasive
a) Reduction of drive and desire to carry out routine
work
b) Avoiding mixing in family and friends(aloof)
c) Reduced efficiency and activity
d) Feeling of passivity(mind and thoughts controlled
by outside force

10. a) Hallucination –auditory and visual are
common, others are very rare.
b) Hallucinations are either structured(human or
animal voice) or unstructured(vague voices)
a) In catatonic, increased psychomotor
activity, stupor, negativism, stereotype, mutism,
verbegeration(repeating the same words)
b) Waxy flexibility

11. a) Excessive day dreaming and fantasy
b) Muttering
c) Spells of laughter and crying without reason
d) Childish behavior
e) Patient passes urine and stool in his clothes
and plays with has own excreta
f) Absent mindedness
g) Makes lot of mistakes in work

12.  THE ILLNESS OF AS A PHENOMENON OF
REGRESSION
 E.G- Reversal to infantile and childhood
patterns of psychological living a state of
organization where reality does not exist.
Thus the patient attempt to resolve his
psychological conflicts by denying the harsh
and painful reality world and living in a
fantasy would full of pleasures

13. A. PARANOID SCHIZOPHRENIA:-
 Early onset
 ‘Paranoia’ means ‘delusional’
 It occurs between 25-30 yrs
 Seen more in males than females
 Delusion of suspiciousness, persecution and
grandeur
 Disorganization of speech and thought
 Hallucinatory voices of threatening or
commanding, also voices of whistling and
laughs

14.  Affect is usually of hostility, anger or
suspiciousness
 Negative symptoms like flat affect, poverty of
speech and poor activity
 Prognosis is good

15. B. HEBEPHRENIC SCHIZOPHRENIA:-
 Early and insidious onset
 Occurs between the age of 20-25 yrs
 Thinking disturbances
 Regression
 Childish behavior
 Inappropriate affect
 Somatic delusion
 Unpredictable, giggling and silliness
 Irrelevant
 Poverty of ideas
 Prognosis is poor

16. C. SIMPLE SCHIZOPHRENIA:-
 Insidious and gradual course
 Occurs between age of 15-20 yrs
 More incidence in males
 Disturbances in affect
 Disturbances in thinking
 Delusions and hallucinations are rare
 Wandering aimlessly
 Prognosis is poor

17. D. CATATONIC SCHIZOPHRENIA:-
 Occurs between age of 20-25 yrs
 Equal in both sexes
 Disturbances of thinking, affect and behavior
 Acute or sub-acute onset
 Autism
 Purposeless excitement and destructive
behavior
 Delusion and hallucinations are common
 Prognosis is good but reoccurs are common

18. E. CATATONIC STUPOR:-
 Absence of speech
 Maintenance of rigid posture against efforts to
be moved
 Negativism
 Bizarre postures for longer period of time
 Stuporous reaction towards surrounding
 Ecolalia-mimicking of phrases and words
 Echopraxia-mimicking of actions observed
 Waxy flexibility
 Ambitendency

19. F. RESIDUAL SCHIZOPHRENIA:-
 Emotional blunting
 Eccentric behavior
 Social withdrawal
 A type of schizophrenia which has been at
least one episode in the past but without
prominent psychotic symptoms at present
G. UNDIFFERENTIATED SCHIZOPHRENIA:-
 Late schizophrenia occurs after 40 yrs of age
 Schizoaffective psychosis with symptoms of
depression and mania and also neurosis
 Prognosis is poor.

20. H. CHILDHOOD OR JUVENILE
SCHIZOPHRENIA:-
 Not common but seen between age of 5-10
yrs and 12-14 yrs
 Onset is acute or gradual
 Prognosis is poor
I. SCHIZOAFFECTIVE PSYCHOSIS:-
 Symptoms of schizophrenia associated with
symptoms of depression and mania

21. J.PSEUDO-NEUROTIC SCHIZOPHRENIA:-
 Core of illness is schizophrenia but presenting
symptoms are suggestive of neurotic symptoms
like anxiety state, phobic reactions, obsessive
compulsive neurosis or hysteria
 Treatment such as psychotherapy, abreactive
therapy or drug therapy is not satisfactory
 Careful psychiatric examination done through
repeated interview, reveals the true nature of
illness

22. 1) Duration of illness:-
Shorter duration carries better prognosis
2) Type of schizophrenia:-
Catatonic and paranoid type carries good
prognosis. simple, hebephrenic, juvenile, pseudo-
neurotic types do not carry good prognosis.
3) Personality:-
Non schizoid and stable
personality respond better

23. 4) Precipitating factor:-
Presence of precipitating factor carries
good prognosis.
5) Age:-
20-30 yrs of age carries better
prognosis than other ages.
6) Type of onset:-
Acute onset carries better prognosis
than gradual onset.

24. I. PSYCHIATRIC HISTORY
II. A MENTAL STATUS
EXAMINATION
III. CLINICAL OBSERVATION
IV. CT SCAN
V. MRI
VI. OFFICIAL DIAGNOSIS IS
BASED ON ICD 10
CRITERIA

25. TREATMENT
A. MODALITIES
PHARMACOTHERAPY:-
 Conventional antipsychotics are now
used less frequently, because of
their only partial efficacy and
adverse effects.
 The following are the drugs given to
non-compliant patients;
-Chlorpromazine:50-
100mg/day
-Fluphenazine decanoate:20-
25mg IM every 1-3 wks
-Haloperidol:5-20mg/day IM
-Trifluoperazine:1-5mg/day IM

26.  Commonly used atypical antipsychotics;
-Clozapine:25-450mg/day PO
-Resperidone:2-10mg/day PO
-Olanzapine:10-20mg/day PO
-Ziprasidone:20-80mg/day PO
 Other drugs used in schizophrenia are mood
stabilizers, anti depressants,
benzodiazepines, etc.

27. B. ELECTROCONVULSIVE THERAPY(ECT):-
 Indications are catatonic stupor, catatonic
excitement
 Severe side effects with drugs
 Usually 8-10 ECT’s are required to be given
 About 8-10 convulsions spread over a period
of 4-6 weeks
C. PSYCHOLOGICAL THERAPIES:-
 Cognitive therapy, group therapy, behavior
therapy, family therapy
D. PSYCHOSURGERY:-
 Prefrontal leucotomy