What Are the Symptoms of Catatonic Schizophrenia?

Tension schizophrenia is a type of schizophrenia and is rare. It often shows that the tension excitement and the tension wood stiffness appear alternately, and it can also happen separately. The wood stiffness state is more common. Most of the onset is young or middle-aged, the onset is relatively rapid, and individual cases can be resolved on their own. Among all types of schizophrenia, the treatment of tension schizophrenia is ideal and the prognosis is best.

Basic Information

Visiting department

Department of Psychology

Common causes

Genetics, neurodevelopment, neurobiochemistry, psychosocial factors

Common symptoms

Often manifested as alternating tension excitement and tension type stiffness, or tension stiffness alone

Causes of tension schizophrenia

1. Genetics: A large number of studies at home and abroad have found that genetic factors play an important role in the occurrence of this disease. The closer to the patient's blood source, the greater the number of relatives with the disease, the greater the risk of disease.
2. Neurodevelopment: Studies have suggested that the occurrence of schizophrenia may be related to neurodevelopmental abnormalities.
3. Neurobiochemistry: It mainly includes dopamine hypothesis, glutamic acid hypothesis, serotonin hypothesis, and -aminobutyric acid hypothesis.
4. Psychosocial factors: Although many studies have shown that the occurrence of schizophrenia is related to psychosocial factors, so far, no psychosocial factors have been found to determine the occurrence of schizophrenia.

Clinical manifestations of tension schizophrenia

Often manifested as alternating tension excitement and tension-type stiffeners, or tension-type stiffeners on their own: often manifested as exercise suppression, slow movements, light words and low movements, and heavy bedridden all day long, silent, not eating He does not respond to surrounding stimuli (such as pain, speech, cold and heat, etc.), saliva stays in the mouth for a long time, does not swallow and vomit, and even flows down the corner of the mouth. Increased muscle tone, waxy flexion, passive obedience, or active violations can occur, as well as imitation of speech (repeat a few meaningless words or phrases), imitation behavior (imitation of other people's behavior). The patient is conscious, and can still perceive the surroundings, and can recall what happened after the illness. It usually lasts weeks to months. May be accompanied by hallucinations or delusions. Nervous excitement: Suddenly, the patient's behavior is impulsive, and it is difficult for ordinary people to understand. The content of the speech is monotonous and rigid, the behavior lacks purpose, and there may be smashing things, hurting people, and destroying things. Spontaneous remission for several hours to several weeks, or a transition to a stiff state.

Stress schizophrenia test

1. General Physical Examination and Nervous System Examination General examination includes observing consciousness, body temperature, pulse, blood pressure, breathing, etc., to know if there are serious infections and signs of organic diseases such as severe physical illness and craniocerebral trauma. The focus should be on the relevant examination of the nervous system, paying attention to the evidence of brain organic disease.
2. Mental examination Comprehensive mental examination, including appearance and behavior, speech and thinking, emotional state, perception, cognitive function, self-knowledge, action behavior, etc. For patients who cannot cooperate, attention should be paid to observe the general appearance and speech of the patient , Facial expressions, action behaviors, etc.
3. Auxiliary examination of blood tests, blood biochemistry, thyroid hormones and other routine tests, EEG, brain CT, brain MRI and other auxiliary examinations, to understand the presence or absence of physical diseases and organic lesions of the brain.
4. Psychological assessment of personality tests such as the retrospective personality development scale (WMPI), the Minnesota Personality Scale (MMPI) and the Eysenck Personality Questionnaire developed by Professor Wang Weidong, and the Symptom Self-Assessment Scale. Self-Depression Scale (SDS) and Hamilton Depression Scale (HAMD).

Diagnosis of Tension Schizophrenia

1. Diagnostic criteria: According to the Chinese Classification and Diagnostic Standards for Mental Disorders 3rd Edition (CCMD-3), the diagnostic criteria for schizophrenia are as follows:
Symptom criteria: At least two of the following are not secondary to a disturbance of consciousness, mental retardation, or emotional ups and downs:
(1) Recurring speech hallucinations.
(2) Obvious slack thinking, broken thinking, incoherent speech, or poor thinking or content.
(3) Thoughts are inserted, removed, disseminated, interrupted, or forced thinking.
(4) Passive, controlled, or insightful experience.
(5) Primary delusions (including delusional perception, delusional mood) or other absurd delusions.
(6) The thinking logic is wrong, pathological symbolic thinking, or new words.
(7) Emotional inversion, or obvious apathy.
(8) Tension syndrome, weird behavior, or stupid behavior.
(9) Obvious decrease or lack of will.
Severe criteria: Impaired self-knowledge and severely impaired social functioning or inability to conduct effective conversations.
[Course standard]
(1) Meeting the criteria for illness and severity has lasted at least 1 month.
(2) If the symptoms of schizophrenia and emotional psychiatric disorders are met at the same time, when the symptoms of schizophrenia are not satisfied, the schizophrenic symptoms must continue to meet the schizophrenic symptoms for at least 2 weeks before diagnosis Schizophrenia.
[Exclusion Criteria]
Eliminate organic mental disorders and mental disorders caused by psychoactive and non-addictive substances. Patients with schizophrenia who have not yet resolved should be diagnosed side by side if they suffer from the two diseases mentioned above.
2. Diagnostic criteria for nervous schizophrenia:
It meets the diagnostic criteria of schizophrenia, with tension syndrome as the predominant one, and tension stiffness is more common. At present, tension schizophrenia has rarely been seen clinically.

Differential diagnosis of tension schizophrenia

1. Organic mental disorder: These patients may also experience mental symptoms such as hallucinations, delusions, personality changes, and disturbances of consciousness. However, most of these patients have abnormal physical, nervous system, and laboratory examinations. They should be thoroughly examined, one by one. exclude.
2. Mood disorders: Many patients with depression may experience mental symptoms such as hallucinations and delusions within a period of time, but the duration of one-way depression is longer, and typical symptoms such as persistent depression, decreased interest, and slow thinking are not difficult. Identification. Symptoms of acute transient mental disorder can also occur during manic episodes. The two differ in their mental associations and continuity, as well as in the form of thinking content, inner experience, and emotional response to surroundings.

Tension schizophrenia treatment

1. Drug treatment Antipsychotics should be used as the first choice. Emphasize the principles of early, sufficient, foot treatment, single medication, individual medication. It should be gradually increased from a small dose to the effective recommended dose. The choice of drug dose growth rate, maintenance dose, and consolidation dose should follow the principle of individualization. The choice of drug should take into account the patient's age, gender, adherence to the drug, individual response to the drug, the size of the adverse reaction, long-term treatment plan, and economic status.
Commonly used antipsychotic drugs are: aripiprazole, sulpiride, risperidone, olanzapine, and quetiapine. The drugs that are more suitable for simple schizophrenia are amisulpride, sulpiride, aripiprazole, and olanzapine are better drugs for negative symptoms, and intravenous sulpiride can also treat tension schizophrenia. Electric shock is effective in treating schizophrenia.
Those who have symptoms of anxiety and depression need to use anti-anxiety and depression drugs together. As antidepressants, 5-HT reuptake inhibitors such as fluoxetine, paroxetine, sertraline can be used. Anxiolytic drugs can be selected from benzodiazepines such as oxazepam, lorazepam, alprazolam, etc. Periodic review of blood pressure, heart rate, blood glucose, blood lipids, liver and kidney functions and other indicators during medication should be performed in time. deal with.
2. Psychological and social intervention (1) Behavioral therapy: based on learning theory, use various methods to train patients with various skills, such as correct decision-making and problem solving, handle interpersonal relationships, correctly respond to stress and bad emotions, and some lives Skills training, etc.
(2) Family intervention: The elements are an organic combination of psychological education, solutions to behavior problems, family support, and crisis management measures.
3. Community services Schizophrenia patients all need to live in the community. Therefore, how to manage schizophrenia patients in the community and how to provide them with convenient, reasonable and efficient services in the community has always been valued by all countries.
4. Electroshock therapy For patients with nervous schizophrenia with stiff and sublime stiffness, electroshock can be used for better results. Generally, 8 to 12 times of electric shock treatment is a course of treatment, starting 3 to 5 times a week, then 2 to 3 times a week, and then reducing to 1-2 times a week.
5. The treatment of tension-type schizophrenia by Chinese medicine is equivalent to the category of "madness" of Chinese medicine. Traditional Chinese medicine believes that Qi depression, blood stasis, phlegm, and fire evil are the main pathogenesis of this disease. Liver and spleen are closely related. Symptoms such as internal disturbance of phlegm and fire and stagnation of qi and blood are more common. Commonly used Chinese medicine prescriptions are: pig iron drop drink, epilepsy and dream awakening soup. Hui and Sun treat patients with tense schizophrenia with wood stiffness and subtree stiffness, and the effect is equivalent to that of non-convulsive electrical shock treatment.