What Is Undifferentiated Schizophrenia?

Undifferentiated schizophrenia refers to a group of patients who meet the diagnostic criteria for schizophrenia, have obvious positive symptoms, but do not meet the diagnostic criteria for paranoid, adolescent, and nervous types, or show more than one type Subtype characteristics but no obvious predominant diagnostic features, including atypical schizophrenia. About 50% of patients develop symptoms between the ages of 20 and 30 years.

Schizophrenia is a clinical syndrome composed of a group of psychotic symptoms and is a multifactorial disease. Although the current understanding of its etiology is still not clear, the role of individual psychological susceptibility and the adverse social environment factors in the occurrence and development of disease have been agreed. Both susceptible quality and external adverse factors may cause the occurrence of diseases through the combined action of internal biological factors. The pathogenesis of different patients may be more prominent in one aspect.
The incidence has a lot to do with the patient's bad personality. The patient's personality is mostly timid, lack of security, unconfidence, self-reliance, excessive attachment and dependence on others, excessive care for others, and lack of strong self. Closely related.

Undifferentiated schizophrenia means that the patient's mental symptoms meet the diagnostic criteria for schizophrenia, and there are obvious psychotic symptoms, such as hallucinations, delusions, disruptive thinking or severe behavioral disorders, but their clinical characteristics should not be classified as delusional. , Youth, nervous type.

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 to determine whether there is evidence of brain organic disease.
2. Mental examination pay attention to the patient's consciousness, pay attention to whether there are positive symptoms such as hallucinations, delusions, and whether the main clinical manifestations are negative symptoms such as loneliness and laziness. Observe the patient's behavior, often accompanied by decreased willpower and lack of self-awareness.
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).

1. Meet the diagnostic criteria for schizophrenia:
At least two of the following are not secondary to disturbance of consciousness, mental retardation, or emotional ups and downs:
(1) Recurring speech hallucinations.
(2) Obvious slack thinking, broken thinking, small coherent speech, or poor thinking or content.
(3) Thoughts are inserted, withdrawn, spread, 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.
2. Course standard: Meet the symptoms and severe standards for at least 1 month.
3. Criterion of severity: Patients with impaired self-knowledge and severely impaired social function or unable to conduct effective conversation.
4. Does not meet the paranoid, youthful or nervous subtype standards.
5. Failure to meet criteria for depression after residual schizophrenia.

1. Organic mental disorder: This type of disorder can also cause mental symptoms such as hallucinations, delusions, personality changes, and consciousness disorders. However, these patients often have abnormal physical, nervous system, and laboratory tests. Exclude them one by one.
2. Affective disorders: Many patients with depression may experience mental symptoms such as hallucinations and delusions within a period of time. However, patients with depression are mainly characterized by persistent depression, decreased interest, and delayed thinking. Hallucinations. Psychotic symptoms such as delusion are not the main clinical manifestations, so it is not difficult to identify them.
During severe manic episodes, psychotic symptoms such as hallucinations and delusions can also occur. Manic episodes and schizophrenia differ in their thinking associations and coherence, as well as in the form of thinking content, inner experience, and emotional response to surrounding things, especially manic The freshness of the emotional response of patients with a panic attack is significantly different from that of schizophrenia. Different disease conditions and drug treatment effects are different, so they can be identified.

1. Drug treatment Regardless of the first episode or relapse of schizophrenia, antipsychotic drug treatment should be used as the preferred treatment. Drug therapy emphasizes the principles of early, sufficient, foot treatment, single medication, and 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 drugs are: risperidone, olanzapine and quetiapine. Drugs with good curative effects include olanzapine and amisulpride. Haloperidol and clozapine also have good curative effects, but the adverse reactions are serious. Most are second-line or third-line medication. 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. During the medication period, blood pressure, heart rate, blood glucose, blood lipids, liver and kidney function and other indicators should be regularly reviewed. Any abnormalities should be promptly detected 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, behavioral problem solving methods, family support, and crisis management measures.
3. Community services Schizophrenia patients ultimately need to live in the community. 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. The treatment of schizophrenia by Chinese medicine is equivalent to the "madness" of Chinese medicine. Traditional Chinese medicine believes that Qi depression, blood stasis, phlegm, and fire evil are the main pathogenesis of this disease. The disease is located in the brain, with the heart, liver, and viscera. The spleen is closely related. Symptoms such as internal disturbance of phlegm and fire and stasis of qi and blood are more common. Commonly used Chinese medicine prescriptions are: pig iron drop drink, epilepsy and dream awakening soup, etc. Acupuncture also has a certain effect on this disease.