Schizophrenia

Clinic

• It is a mental Disease characterized by continuous or relapsing episodes of psychosis.
• Major symptoms include Hallucinations (typically hearing voices), Delusions, and Disorganized thinking.
• Other symptoms include Social withdrawal, Decreased emotional expression, and Apathy.
• Symptoms typically develop gradually, begin during young adulthood, and in many cases never become resolved.
• Most of them have other mental disorders, esp Substance use disorders, Depressive disorders, Anxiety disorders, and OCD.

Sign / Symptoms

Positive	Negative	Cognitive
Delusions, hallucinations, and disorganized thoughts and speech, typically regarded as manifestations of psychosis. Hallucination (80% of Cases) most commonly involve hearing (Often hearing voices) but other senses maybe involved. Hallucination are also typically related to the content of the delusional theme. Delusions are bizarre or persecutory in nature. Thought disorders can include Thought blocking, and Disorganized speech. The best rubrics are Delusion Hallucination Psychosis	Apathy includes Avolition: Lack of motivation, Blunted affect – showing flat expressions or little emotion Anhedonia: Inability to feel pleasure Asociality: Lack of desire to form relationships / Social withdrawal Diminished expression includes blunt affect Alogia: Poverty of speech In 50%, it is related to disrupted cognitive processing affecting memory and planning including goal-directed behavior. Avolition and anhedonia are seen as motivational deficits resulting from impaired reward processing. The best rubric are Depression Altered Thought pattern	Cognitive symptoms (70%) are most pronounced in early onset and late-onset illness. These are often evident long before the onset of illness in the prodromal stage. Cognitive deficits are core features and may be of Neurocognition (nonsocial) or of Social cognition. Neurocognition is the ability to receive and remember information, includes verbal fluency, memory, reasoning, problem solving, speed of processing, and auditory and visual perception. Mostly Verbal memory and attention are affected. Verbal memory impairment is associated with a decreased level of semantic processing (relating meaning to words). Episodic memory. An impairment in visual perception that is consistently found in schizophrenia is that of visual backward masking. Visual processing impairments include an inability to perceive complex visual illusions. Social cognition is concerned with the mental operations needed to interpret, and understand the self and others in the social world. This is also an associated impairment, and facial emotion perception is often found to be difficult. Facial perception is critical for ordinary social interaction.

Sub types

Paranoid Schizophrenia	Catatonic Schizophrenia	Residual Schizophrenia	Disorganized Schizophrenia
Usually manifests itself in intense and nonsensical suspicions Auditory hallucinations that confirm their suspicions. Disorganized behavior and speech patterns, are usually not present NVCJD is good candidate.	Moving too much or too little. Motionless and resist any attempts to move them, staying rigid and stationary. Purposeless movement including repeat what others say over and over, and mimic the movements of those around them. They may also make strange faces or body contortions, and engage in rocking, waving, or nail-biting. Considering Rigidity, good candidates would be RBS and JE	Residual schizophrenics are not currently experiencing any of the more serious symptoms of schizophrenia, including no signs of hallucinations, disorganized speech, or catatonic behaviors. However, they will experience at least two minor symptoms, such as odd beliefs, trouble paying attention, withdrawing from society, and talking less. Considering Delusion and Altered thought pattern, Psychosis and Depression, the best candidate would be EBV and JE	Disorganized schizophrenia is primarily distinguished by “disorganized” symptoms such as disorganized speech, behavior, and inappropriate behavior. This can include resisting eye contact, the inability to make facial expressions, incoherence, and trouble beginning or finishing a task.

Undifferentiated Schizophrenia

• If somebody diagnosed with schizophrenia has trouble classifying themselves into any of the above subtypes but still experience symptoms, they will be labeled as someone with undifferentiated schizophrenia.

Schizophrenia Black Box

Four stages:

1. Free-will
   • Human-being has free will around the axis of self.
   • "Free-will" make and support "Self".
   • So self is not a meaningful identity without free-will.
   • You make yourself by your thinking / behaviors. Probably you imitate someone, then what makes these thinking / Behaviors, yours? Of course your free-will.
   • This is your identity, therefore you are caring it Uninterruptedly
   • Free-will did not exist from the beginning, therefore you make it through evolution since you need it.
   • It is vital for your survival so anything that threatens it is considered an emergency.
   • That's why hallucinations of RBS is so wild, since this virus attack the center of you, which is your self-identity.
   • This is the state of Delirium and if it is not solved, it would be push you to the state of Paranoid mania. In this stage the patient have transient Hallucination with or without Delusions.
   • Here Alum is the best choice
2. Paranoia
   • The second stage would be Paranoid Schizophrenia. In this stage thought pattern is destroyed.
   • Hyos and lach is the best
3. The patient loose his movement control which is named Catatonic Schizophrenia.
   • Since his movement system is intact, he has purposeless movement which is named Stereotypy or purposeless immobility which is incorrectly named Rigidity.
   • Cupr and Plb are the first choice
4. The end stage of this sinister story is Hebephrenic Schizophrenia. in this stage the patient enters a persistent disorganizing of will which is the meaning of skhizein= split phrēn= mind.

	RBS	JE	EBV	NVCJD
Psychosis	+++	+++	+++	+++
Auditory H				+++
Depression		+++	+++	+++
Altered Pattern of thought	+++	+++	+++
Behavioral change	+++	+++	+++	+++
Cognition impaired	+++	+++	+++	+++
Memory weakness	+++	+++	+++	+++
Rigidity	+++	+++
Sub types	Catatonic	Catatonic Residual	Residual	Paranoidal
	LYSS, STRAM, BELL, Nux-v, Lach, Cupr, Hyos, Phos, Cic, Tarent, Sul, Anac, Bufo, Hell, Op, Verat	CUPR, MERC, Nux-v, Lach, Phos, Hyos, Bell, Sul ,Stram, Agar	ARS, PHOS, Nux-v, Carc, Merc, Sul, Ign	BELL, Stram, LACH