SCHIZOPHRENIA – SYMPTOMS

Explanation:

Chronic subdral haematoma

Explanation:

Catatonic schizophrenia is associated with most obvious and dramatic motor disturbances and other features of schizophrenia.

Most studies conclude that rates of catatonia in Schizophrenia amounts to around 5%.

There is a decline in the diagnosis of catatonic schizophrenia, possibly due to the differences in the diagnostic categories and the availability of more effective psychotropic drugs.

Ref: Catatonia: From Psychopathology to Neurobiology By Stanley N. Caroff, 2004, Page 16; Kaplan and Sadock’s Synopsis of Psychiatry: By Benjamin J. Sadock, Harol I. Kaplan, Virginia A. Sadock, 2007, Page 541.

Explanation:

Increased speech production is seen in excited catatonia.

Explanation:

According to the DSM IV, Schizophrenia is classified into 5 types, paranoid, catatonic, disorganized, undifferentiated and residual.

Simple schizophrenia is included only under the ICD 10 classification.

Among the following, paranoid subtype has a more favorable prognosis.

Prognosis of catatonic is nearly as good as paranoid, undifferentiate type is associated with intermediate prognosis and hebephrenic type is associated with poor prognosis.

Ref: Current Diagnosis and Treatment : Psychiatry 2e, chapter 16.

Explanation:

A. i.e. Catatonic schizophrenia

Explanation:

> A. i.e. Ganser state; B. i.e. Conversion hysteria; C. i.e. Catatonic schizophrenia

Explanation:

A. i.e. Severe depression; B. i.e. Conversion disorder

• Catatonia is a hypomobile & mute syndrome that arises as a part of major psychosis, usually schizophrenia or major depressionQ, and rarely manic stupor, reactive psychosis, and periodic catatonia. It may also occur in conversion & dissociative disorderQ and during hypnosis.
• Catatonic patients make few voluantary or responsive movements, although they blink, swallow, & may not appear distressed. However, signs that patient is responsive; for example blinking in response to visual threat, concomitant eye movement with head rotation and active resistance of eyelid elevation are present, all of which are inconsistent with the presence of a brain lesion. It is differentiated from akinetic mutism by absence of evidence of cerebral damage such as Babinski sign & hypertonicity.

Explanation:

B i.e. Catatonic schizophrenia

Explanation:

D i.e. All of the above

Explanation:

B i.e. Catatonic schizophrenia

Explanation:

D. i.e. Deep tendon reflexes are increased

Explanation:

C. i.e. Catatonic

Explanation:

D. i.e. Catatonic

Explanation:

D. i.e. Flight of ideas

Explanation:

D. i.e. Gegenhalten

Gegenhalten or paratonia is seen in frontal lobe diseases present in schizophreniaQ.

Muscle Tone

It is the resistance of muscle to passive stretch. It may be increased or decreased and is usually associated with weakness or paralysis of muscle. Disorder include

Explanation:

C i.e. Catatonic SZP

Explanation:

C. i.e. Catatonic schizophrenia

Explanation:

Ans. a and b both

Explanation:

Ans:A.)Persistent and inappropriate repetition of the same thoughts

Perseveration

• It is the repetition of a particular response (such as a word, phrase, or gesture) despite the absence or cessation of a stimulus.
• It is usually caused by a brain injury or other organic disorder.
• Symptoms include “lacking ability to transition or switch ideas appropriately with the social context, as evidenced by the repetition of words or gestures after they have ceased to be socially relevant or appropriate”, or the “act or task of doing so”, and are not better described as stereotypy (a highly repetitive idiosyncratic behaviour).

Associated Conditions:

• Perseveration is particularly common with those who have had traumatic brain injury.
• Perseveration is sometimes a feature of frontal lobe lesions, and of other conditions involving dysfunction or dysregulation within the frontal lobe. This is especially true when the lateral orbitofrontal cortex or inferior prefrontal convexity (Brodmann areas 47/12) are affected.
• Perseveration is also sometimes seen as a symptom of aphasia.
• Perseveration may also refer to the obsessive and highly selective interests of individuals on the autism spectrum. This term is most connected to Asperger syndrome.
• In attention deficit hyperactivity disorder (ADHD), perseveration or “hyperfocus” commonly occurs [8] as an impairment of set shifting and task switching.The resistance to transition may be a coping mechanism or the brain’s method to compensate for the lack of ability to regulate the application of attention.
• In people who are both intellectually gifted and suffer a learning disability, the state of hyperfocus and flow can be confounded with perseverance.
• Apart from their direct symptoms, people with obsessive–compulsive disorder can have specific problems with set shifting and inhibition of prepotent responses

Explanation:

Ans. Inability to experience pleasure from normally pleasurable life events

Explanation:

Ans. Cataplexy

Explanation:

Ans. Paranoid schizophrenia

Explanation:

Ans. is ‘a’ i.e., Agitation

• Agitation is seen in excited catatonia (not is stupor catatonia).
• Features of catatonic schizophrenia may be :‑

1. Excited catatonia :- It is characterized by increased in psychomotor activity, i.e. restlessness, agitation, excitement, aggressiveness, violence. The impulsive activity occurs in response to hallucination and delusions.
2. Stuporous (retarted catatonia) :- It is characterized by extreme retardation of psychomotor activity. It includes mutism, rigidity, negativism, posturing, stupor, echolalia, echoproxia, catalepsy (waxy flexibility), ambitendency, gegenhalten, stereotypies, stupor, mannerism, Grimicing, automatic obedience.

Explanation:

Ans. is ‘b’ i.e., Depression

Explanation:

Answer- C. Strength of antagonists remains the same as examiner uses increased force to change limb position

It is ako called paratonia or paratonic rigidity.

• It is the voluntary opposition of patient to passive movement of limb.
• It is the movement of the limb to counteract any movement made by the examiner.
• The resistance offered to passive movement is variable and fluctuating in nature.

Patient is unable to relax a group of muscles on command due to inattentiveness.

• Strength of antagonists increases as examiner uses increasing force to change the limb position.

Resistance is present throughout the range of motion.

• It is also described as stifening of limb in response to contact.
• It is a sign of bilateral frontal lobe dysfunction” especially mesial cortex and superior convexity

Explanation:

Ans. (A) Waxy flexibility (B) Automatic obedience (C) Somatic passivicity (D) Rigidity (E) Mutism

[Ref: Neeraj Ahuja e p. 63; Essentials of clinical psychiatry 4th/e p. 635]

Features of catatonic schizophrenia may be :–

l) Excited catatonia:

• Characterized by increased psychomotor activity, i.e. restlessness, agitation, excitement, aggressiveness, violence. The impulsive activity occurs in response to hallucinations and delusions.

2) Stuporous (retarted catatonia) :

• Characterized by extreme retardation of psychomotor activity.It includes mutism, rigidity, negativism, posturing, stupor, echolalia, echopraxia, catalepsy (waxy flexibility), ambitendency, gegenhalten, stereotypes, stupor, mannerism, Grimacing, automatic obedience.