What Is Catatonic Schizophrenia?

Schizophrenia is a group of severe psychiatric disorders of unknown etiology. It usually develops slowly or subacutely in young adults, and often manifests as a syndrome with various symptoms in the clinic. It involves multiple obstacles such as perception, thinking, emotion and behavior And inconsistent mental activity. Patients are generally well aware and their intelligence is basically normal, but some patients will suffer cognitive impairment during the course of the disease. The course of the disease is generally prolonged, with recurrent attacks, exacerbations, or worsening. Some patients eventually experience decline and mental disability, but some patients can remain fully or substantially cured after treatment.

Basic Information

English name: schizophrenia
Visiting department: Psychiatry
Multiple groups: Young adults

Common causes: Family history, environmental factors, diseases, stress, psychological and other factors
Common symptoms: Hallucinations, delusions, irritability, depression and anxiety, cognitive impairment

Causes of Schizophrenia

Schizophrenia is a clinical syndrome made up of a group of symptoms. It is a multifactorial disease. Although the current understanding of its etiology is still not clear, the role of individual psychological susceptibility and external social environment factors in the occurrence and development of the disease has been widely recognized. Both susceptible quality and external adverse factors may cause the occurrence of diseases through the combined effects of internal biological factors. The pathogenesis of different patients may be more important in some aspects.

Clinical manifestations of schizophrenia

Clinical manifestation

The clinical symptoms of schizophrenia are complex and diverse, and can involve perception, thinking, emotion, will behavior, and cognitive functions. Symptoms vary greatly from individual to individual. Even the same patient may show different symptoms at different stages or stages. .

(1) Perceptual disturbances. Schizophrenia can occur with various perceptual disturbances. The most prominent perceptual disturbances are hallucinations, including hallucinations, hallucinations, hallucinations, hallucinations, and hallucinations. Hallucinations are the most common.

(2) Thinking disorder Thinking disorder is the core symptom of schizophrenia, mainly including disorder of thinking form and content of thinking. Obstacles to thinking form are mainly manifested by obstacles in the process of thinking association, including obstacles in the process of thinking association activity (volume, speed and form), and the continuity and logic of thinking association. Delusion is the most common and important obstacle to thinking content. The most common delusions are victim delusions, relationship delusions, influence delusions, jealous delusions, exaggerated delusions, non-blood delusions, etc. It is estimated that up to 80% of patients with schizophrenia have a delusion of victimization. The delusions of victimization can manifest as different degrees of insecurity, such as being monitored, excluded, worried about being administered drugs, or murdered. Under the influence of delusions, patients will make Defensive or aggressive behavior. In addition, passive experience is also prominent in some patients, which affects patients' thinking, emotions and behaviors.

(3) Affective disorders Emotional apathy and uncoordinated emotional responses are the most common emotional symptoms in patients with schizophrenia. In addition, uncoordinated emotional symptoms such as excitement, irritability, depression and anxiety are also common.

(4) Will and behavior disorders Most patients have reduced or even lack of will, manifested as reduced activity, solitude, passive behavior, lack of due enthusiasm and initiative, decreased interest in work and study, do not care about the future, and have no future. Explicitly, some patients may have plans and intentions, but they are rarely implemented.

(5) Cognitive dysfunction The incidence of cognitive impairment is high in patients with schizophrenia, and about 85% of patients have cognitive dysfunction, such as information processing and selective attention, working memory, short-term memory and learning, executive function And other cognitive deficits. There is a certain correlation between the symptoms of cognitive deficits and other psychotic symptoms. For example, the symptoms of cognitive deficits are more pronounced in patients with significant form disorders, the symptoms of cognitive deficits are more obvious in patients with significant negative symptoms, and cognitive deficits may be related to certain positives. Symptoms are related. Cognitive deficits may occur before the psychiatric symptoms become clear (such as the prodromal phase), or they decline sharply with the onset of psychiatric symptoms, or they gradually decline as the course of the disease increases. Cognitive deficits are more pronounced in patients with schizophrenia.

2. Clinical typing

(1) Paranoid type This is the most common type of schizophrenia, with hallucinations and delusions as the main clinical manifestations.

(2) Adolescents Onset in adolescence, with prominent thinking, emotional and behavioral disorders as the main manifestations, typical manifestations are diffuse thinking, broken thinking, emotional and behavioral responses are naive, and may be accompanied by fragmented hallucinations and delusions; some patients It can manifest as hyperactive instincts, such as increased appetite and sexual desire. This type of patient has a low onset age, has an acute onset, has significant impairment of social function, and generally has a poor prognosis.

(3) Tense type With tension syndrome as the main manifestation, patients can present with tension stiffness, waxy flexion, stereotyped words and deeds, and uncoordinated psychomotor excitement and impulsive behavior. Generally, this type of patients has an acute onset, and some patients respond quickly.

(4) Simple type This type mainly occurs in adolescence, and is mainly manifested as negative symptoms, such as lonely withdrawal, flat emotion or indifferent. The effect of this type of treatment is not good, the patient's social function declines significantly, and the prognosis is poor.

(5) Undifferentiated type This type has some of the characteristics of one of the types mentioned above, or some of the characteristics of the above types, but it is difficult to classify any of the above types.

(6) Residual type This type is the period after the acute phase of schizophrenia, and is mainly manifested as a change in personality or a decline in social function.

Schizophrenia diagnosis

Commonly used diagnostic standards abroad include the American Disease Classification and Diagnostic Statistics Manual DSM-IV-TR, and WHO's International Disease Classification Manual ICD-10. The commonly used domestic diagnostic standards are the Chinese mental disorder classification and diagnostic standard CCMD-3.

Differential diagnosis of schizophrenia

Schizophrenia usually needs to be distinguished from mental disorders caused by organic diseases, mental disorders caused by drugs or psychoactive substances, mood disorders, paranoid mental disorders, and obsessive-compulsive neurosis.

Schizophrenia treatment

Antipsychotic drug treatment is the first choice for schizophrenia. Drug treatment should be systematic and standardized, emphasizing early, adequate, and foot treatment. Pay attention to the principle of single medication and individual medication. Second-generation (atypical) antipsychotic drugs such as risperidone, olanzapine, and quetiazone are generally recommended as first-line drugs. Clozapine, the first-generation and atypical antipsychotic, is used as a second-line drug. Some patients with acute stage or patients with poor efficacy can be treated with electroconvulsions.

10% to 30% of patients with schizophrenia are ineffective and are called refractory schizophrenia.