PGI Exam

Other special features of depression

Types of Schizophrenia With psychotic features: Patients with severe depression may develop psychotic symptoms [Delusions / Hallucinations] Psychotic Symptoms may be mood congruent [Like Nihilistic] or mood incongruent [grandiose] Only present in severe depression and hence sometimes called psychotic depression With atypical features: Reversal of biological symptoms [Hypersomnia, overeating and weight gain] With melancholic features: […]

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Depression

Depression Major depressive episode in absence of any manic, mixed or hypomanic episode One of the commonest psychiatric disorder [Lifetime prevalence 17%] Twice as prevalent in Women, Mean Age = 40 Years Responsible for Maximum DALY [Disability Adjusted Life Years] Most common cause of Suicide More commonly seen in divorced and separated persons Endogenous Vs

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Types of Schizophrenia

Types of Schizophrenia Types of schizophrenia according to ICD-10 classification: Paranoid: Predominated by hallucinations & Delusions but personality usually preserved Most common type, Late Onset, Good Prognosis Catatonic: Predominated by catatonic symptoms, BEST Prognosis First Line Treatment – I/V Lorazepam & Electroconvulsive therapy Hebephrenic: Prominent disorganization symptoms and negative symptoms Early Onset, Bad Prognosis and

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Side effects of typical antipsychotics

Side effects of typical antipsychotics The side effects of typical antipsychotics include: Movement disorders Endocrine effects Sedation Movement disorders: Movement Disorders also called Extrapyramidal Symptoms Caused by Blockage of Dopamine receptors in Nigrostriatal tract Acute dystonia: Earliest Side Effect. Sudden contraction of a grp. of muscles [torticollis, trismus, deviation of eye] Mgt – I/V Anticholinergics

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Schizophrenia-Positive Symptoms

Schizophrenia-Positive Symptoms The symptoms of schizophrenia are divided into: Positive Negative Disorganization Motor Positive symptoms: Include – Delusions and Hallucinations Good Prognostic Factor and Responds well to medications Delusions – BIZZARE Delusions, M/C Delusion – Delusion of Persecution Hallucination – M/C Auditory Hallucinations Visual Hallucination if present may raise the suspicion of organic mental disease

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Etiopathogenesis of schizophrenia-Genetic factors

 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

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