Articles from Ramamental

[Pages:7]Articles from Ramamental

(Schizophrenia)

2011-12-05 10:12:30 admin

(s ch izo p hrenia)

. (PositiveS ymptom s) 2

1) Psychotic dimension

2) Disorganization dimension disorganized behavior disorganized speech

(Delusion) persecutory delusion, delusion of reference Schneider delu sion Schnesidoemratic de lusbioizna,rrreeligdieoluussiodnelusbioiznarre dgerlaunsdioio nse

(Ha llucinat ion) auditoryhallucination

tactile somatic

hallucination auditory hallucination

Schneider

Dasissoorcgiaant ioi znesd,sinpceoehcehrentspeech, tangentia lity loose

Disorgan izedbeh avior

. (NegativeSy m ptoms)

Alogia

Affective flattening

Avolition Asociality

(pa thognomonic) 1. Au dib leth o ughts 2. Voic e sarguing ( ) 3. Voices commenting 4.Som aticp ass ivit y 5. Thought withdrawal 6. Thought insertion 7. Thought broadcasting 8.Del usional perce pt ion 9.De lusionofcontrol A. 2 1 1. 2. 3. disorganized speech 4. grossly disorganized behavior catatonic behavior 5. flat affect, alogia avolition bizarre delusion, voice commenting voice discussing B. social/ occupational function C. 6 active phase ( A) 1 prodromal residual phase

 DSM-IV 5 1. Catatonic type stupor, negativism, rigidity, excitement posturing

2. Disorganized type incoh erence ,loo senin gcoaftaas tosnoicciatytipoen , 15-25

3. Paranoid type catatonic disorganized type 2 2 4.Und ifferentiat edtype 3 5. Residual type 1

0.1-0.5 1000 2.5-5.3 1000 (lifetime prevalence) 7.0-9.0 1000 15-54

.

1. ( 2)

2.

(dopa minemheyspoolitmhebsicis)mes oc ortica l tractdop aminergichyp eract ivity

post-

synaptic receptor dopamine

receptor type 2

2.

( ) ( )

(%) 1.0 8.0 12.0 12.0 40.0 47.0

3. ventricle limbic periventricle

4. cerebral blood flow glucose metabolism frontal lobe

.

1.

(criticis m ) ((heoxsptrileitsys) ed- emo t ion) (emotional overinvolvement)

2. drifthypoth esis ) (s(doocwianl ward causation hypothesis)

s tress-diathesismodel

1. Secondary and substance-induced psychotic disorders deliriu m

2. Mood disorders mania depression vegetative symp toms

3. D elusional d isorder delusional diso rder 4. Personality disorder cluster A

3

. (prodromal phase)

1

. (ac tivephase) A

. (residual phase) flat affect 25 2-3 (complete remission) (incom ple teremission)

3 The natural history of schizophrenia : a five-year follow-up

22 % 1

35 % 2

(impairment)

8% 3

35% 4

( 4 ) 4.

1. 2. 3.

4. 5. paranoid catatonic 6. 7. 8. mood disorders 9. 10.

1. 2. 3. 4. 5. disorganized undifferentiated 6. 7. 8. 9. 10.

. 1. 2. 3. 4.

3-6 . 2 1) (sedatingeffect) chlorpromaz ine300-500 ben./zodiaz ehpainloeperidol 6 -1 0./ 2 2) 10 0300 . chlorpromazine long acting 5 1 . (electroconvulsive therapy) E CT catatonic severe depression . 1) (ps y choth erap y)

2) ( fa milyco u n se l in g o rpsychoed uc a tion) 3) (grouptherapy) 4) (milieu therapy)

1. Andreasen NC, Flaum M. Schizophrenia: the characteristic symptoms. Schizophr Bull 1991; 17 : 27-49.

2. Black DW, Yates WR, Andreasen NC. Schizophrenia, schizophreniform disorder, and delusional disorder. In: Talbott JA, Hales RE, Yudofsky Sc, eds. American Psychiatric Press Textbook of Psychiatry, 2nd ed. Washington, DC: American Psychiatric Press, 1994: 411-61.

3. Carpenter WT, Conley RR, Buchannan RW, Breie A, Tamminga CA. Patient rsponse and resource management: another view of clozapine treatment in schiophrenia. Am J Psychaitry 1995; 152: 827-832.

4. Kane JM, Marder SR. Psychopharmacologic treatment of schizophrenia. Schizophr Bull 1993; 19: 287-302.

5. Kaplan HI, Sadock BJ, Grebb JA, eds. Synopsis of Psychiatry, 7th ed. Baltimore: Williams and Wilkins, 1994: 457-68.

6. Mellor CS. First rank symptoms of schizophrenia. Br J Psychiatry 1970;117:15-23.

7. Siris SG. Diagnosis of secondary depression in schizophrenia : Implication for DSM-IV. Schizophr Bull 1991; 17(1):75-98.

8. Tsuang MT, Loyd DW. Schizophrenia. In: Winokur G, Clayton P, eds. The medical basis of psychiatry. Philadelphia: W.B.Saunder Company, 1986: 80101.

9. World Health Organization. The ICD-10 classification of mental and behavioral disorders. Geneva: World Health Organization, 1992: 86-95.

10. Zubin J, Steinhauer SR, Condray R. Vulnerability to relapse in schizophrenia. Br J Psychiatry 1992; 161(Suppl): 13-8.

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