Friday, April 13, 2018

Schizophrenia: Types and Prognosis mnemonic

Schizophrenia: Types and Prognosis mnemonic.

So to begin with, Schizophrenia is a psychiatric disorder classified under psychosis.
Psychosis is a mental state involving loss of contact with reality, causing deterioration of normal social functioning. 

Features of psychosis are:
Loss of insight.
Marked disturbance in personality and behaviour.
Loss of contact with reality.
Impairment in judgement.
Presence of delusions and hallucinations.

A quick recap : Psychosis is classified as   -

• Organic e.g. Substance related psychosis, head trauma
• Major e.g. Schizophrenia, mood disorders
• Third psychosis e.g. delusional disorder, acute and transient psychotic disorders.

There are 7 types of schizophrenia and the mnemonic goes like
PHC (primary health centre) U R SO far

1. Paranoid: The commonest type and good prognosis. The onset is later in life 3-4th decade. Major symptoms are delusion of persecution and grandeur.

2. Hebephrenic: 2nd most common and the worst prognosis. Disorganisation of thought, speech, affect and personality is more prominent than other types. Also there is marked emotional impairment.

3. Catatonic: The best prognosis (especially reactive catatonia). Characterised by marked disturbance in motor activity. Further divided into 3 forms i.e. Excited, Stuporous, and one alternating between the two.

4. Undifferentiated: Where symptoms do not fit in any subtypes.

5. Residual: Chronic type where the positive symptoms vanish and patient is left with 'residual' negative symptoms

6. Simple: only negative symptoms from onset (no positive symptoms at all)

7. Others (f): 
Schizophrenia + mental retardation = Pfropf syndrome
Schizophrenia + self-mutilation = Van-Gogh syndrome

Now let us see what exactly we mean by positive and negative symptoms.
Positive symptoms are those psychotic symptoms not seen in normal individuals (of course, haa!) but are “actively expressed” in the patients (something is added extra and so called positive).

Negative symptoms are normally expected behaviours like emotions like feelings thoughts and drives that a normal person experiences are absent in the patient (Normal things are being taken away and so called negative).

That’s all for now,
Stay awesome!
Keep calm and keep studying!
-Ashish G. Gokhale

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