Schizophrenia-Epidemiology Prevalence of schizophrenia Incidence Rate 0.15-0.25 Per 1000 General population 1% Non twin sibling of schizophrenic patient 8% Dizygotic twin of schizophrenic patient 12% Monozygotic twin of schizophrenic patient 47% Child with 1 schizophrenic parent 12% Child with both parents’ schizophrenic 40% Usual Age of onset in Adolescence & Young Adulthood [If age > …
Etiopathogenesis of schizophrenia-Genetic factors The etiopathogenesis of schizophrenia consists of following factors: Genetic Biochemical Neuropathological Genetic Factors: Nine Linkage sites identified – 1q, 5q, 6p, 8p, 10p, 13q, 15q, 22q α- 7 nicotinic receptor DISC 1 [Disrupted in Schizophrenia] COMT [Catechol-o-methyl transferase] NRG 1 [Neuregulin 1] GRM 3 [Glutamate receptor metabotropic] RGS 4 [Regulator …
Etiopathogenesis of schizophrenia-Genetic factors Read More »
Etiopathogenesis of schizophrenia-Biochemical factors The etiopathogenesis of schizophrenia consists of following factors: Genetic Biochemical Neuropathological Biochemical factors: Dopamine Hypothesis – Excess of dopaminergic activity Serotonin – Currently along with dopamine excess of serotonin is also considered Other Neurotransmitter – GABA, NE, Ach, Nicotine, Glutamate
Schizophrenia-Disorganization symptoms The symptoms of schizophrenia are divided into: Positive Negative Disorganization Motor Disorganization symptoms: Formal Thought disorder – Loss of organization of thought Disorganized behavior – inappropriate behavior which breaks social norms Inappropriate affect – Affect which is not in sync with the social situation
Schizophrenia-Diagnosis Diagnosis of Schizophrenia: Delusions Hallucinations Disorganized Speech [ Formal thought disorder] Disorganized or Catatonic behavior Negative Symptoms DSM 5 2 or More of above for > 1months [with one from [1], [2] or [3] Duration of Illness > 6 Months ICD-10 2 or More of above for > 1months [with one from [1], …
Schizoaffective disorder Has both features of Schizophrenic and mood disorders Schizoaffective disorder [Bipolar or manic type] Schizoaffective disorder [Depressive type] Management Mood Stabilizers, Antipsychotics and Antidepressants
Other antipsychotics Long Acting Injectable [Depot] Antipsychotics used in patients with poor compliance Available for Fluphenthixol Fluphenazine Haloperidol Pipotiazine Risperidone Zuclopenthixol Olanzapine Paliperidone Aripiprazole Thioridazine can cause irreversible retinal pigmentation, QT Prolongation but Less EPM side effect Chlorpromazine with corneal and lenticular deposits Penfluridol is the longest acting antipsychotic Ziprasidone can cause QT Prolongation …
Delusional disorder Delusional disorder: Development of a single or a set of related delusion which are persistent Hallucination, disorganization and negative symptoms are absent Persecutory Type, Jealous Type, Erotomania Type, Grandiose Type Somatic Type – Delusional parasitosis, Delusional dysmorphophobia, Delusion of Halitosis Capgras Syndrome – Familiar person has been replaced by an imposter Fregoli …
Clozapine First Atypical antipsychotic and is Drug of Choice in RESISTANT Schizophrenia Low D2 Affinity [Lack of Extrapyramidal S/E]and Strong D4 Affinity Antagonist of 5HT2A, D1, D3 and Alpha-adrenergic receptor Preferred Antipsychotic in patient who with EPM side effects including tardive dyskinesia S/E – Sedation, Syncope, hypotension, tachycardia, Nausea & Vomiting, Weight Gain [Highest], …
Acute psychotic disorder Delusion, hallucination and disorganization symptoms like schizophrenia Does not meet the duration criteria for diagnosis of schizophrenia Preceded by STRESSOR [Stressful Life Event] and may be precipitated by Fever ICD -10 [Acute & Transient Psychotic Ds] DSM5 [ if Duration < 1 Month Brief Psychotic Disorder Duration 1-6 Months – Schizophreniform Disorder] …
