Facts on Mental Health

Schizophrenia is a heterogenous syndrome characterized by disturbance in language, perception, thinking, social activity, affect and volition. There are no pathogenic features. The syndrome commonly begins in late adolescence, has an insidious (and less commonly acute) onset, and, clasically, a poor outcome, progressing from social withdrawl and perceptual distortions to a state of chronic delusions and hallucinations. Patients may present with positive symptoms (such as conceptual disorganization, delusions or hallucinations) or negative symptoms (loss of function, anhedonia, decreased emotional expression, impaired concentration and diminished social engagement) and must have atleast two of these for a 1 month period and continuous signs for atleast 6 months to meet formal diagnostic criteria. "Negative" symptoms predominate in one-third of the schizophrenic population and are associated with a poor long-term outcome and a poor response to drug treatment. However, marked variability in the course and individual character of symptoms is typical.

The four main sub-types of schizophrenia are:

1) Catatonic

2)  Paranoid

3) Disorganized

4) Residual

Many individuals have symptoms of more than one type.

Catatonic Type : Catatonic-type describes patients whose clinical presentation is dominated by profound changes in motor activity, negativism, and echolalia or echopraxia.

Paranoid Type : Paranoid-type describes patients who have a prominent preoccupation with a specific delusional system and who otherwise do not qualify as having disorganized-type disease.

Disorganized Type : In Disorganized-type schizophrenia, disorganized speech and behavior are accompanied by a superficial or silly affect.

Residual Type : In Residual-type disease, negative symptoms exist in the absence of delusions, hallucinations or motor disturbance.

The term schizophreniform disorder describes patients who meet the symptom requirements but not the duration requirements for schizophrenia, and schizoaffective disorder is used for those who manifest symptoms of schizophrenia and independent periods of mood disturbance. Prognosis depends not on symptom severity but on the response to anti-psychotic medication. A permanent remission without recurrence does ocassionaly occur. About 10% of schizophrenic patients commit suicide.