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/ Apathy	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.	Avolition: Lack of motivation, Blunted affect – showing flat expressions or little emotion Anhedonia: Asociality / Social withdrawal Diminished expression includes blunt affect Alogia: Poverty of speech Disrupted cognitive processing affecting memory and planning including goal-directed behavior. Avolition and anhedonia are seen as motivational deficits resulting from impaired reward processing.	Mostly (70%)pronounced in early onset and late-onset illness. They are core features and may be of Nonsocial or of Social cognition. Neurocognition/ Nonsocial 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: Mental operations needed to understand the self and others in the social world. Impairment of facial emotion perception that is critical for ordinary social interaction.
The best rubrics are Delusion Hallucination Psychosis	The best rubric are Depression Altered Thought pattern	The best rubric are Cognition impaired

Sub types

Paranoid	Catatonic	Residual	Disorganized
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	They are not currently experiencing any of the more serious symptoms, 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	It 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 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.

Four stages of Schizophrenia

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

Remedies

First class	Top character		Delusions Halucinations	Speech
Lach	Top remedy High Degree of Suspiciousness/ Paranoia Loquacity Restless Jealous Religious	Restless and uneasy: Does not attend business. Wants to be off somewhere all the time. Mental labor best performed at night, euthanasia Nightly delusion of fire Derangement of the time sense. Amative, but Sad/ Apathic in the morning.	Paranoid delusions High suspicion: Being poisoned, harmed, being pursued by enemies. Being under control of a superhuman power Apathy: Wish to isolate themselves, aversion to work	Marked loquacity Continuously talking with quick jumps from one to another unrelated subject. Repetition of the same words over and over again
Anac	Auditory Hallucinations Violence / Abusive Suspicion Double being sensation Blasphemy Low self confidence As if possessed of two persons or wills	Violence / Malicious Very easily offended. Excessive anger at the slightest offense. Suspicion: Anxiety when walking, as if pursued ُSad: Aversion to work Unreal sensation	Auditory Hallucinations The voices are mostly of spirits or dead people. The voices say that they are going to die soon. Spirits call their name and command to follow them. The voices are abusive	Profound melancholy Hypochondriasis Senile dementia: Absent-minded / Forgetful/ Brain-fag Immoral Abusive and curse
Hyos	Delusion of Being Poisoned Foolish behavior Shameless Increased sexual desire Conspiracy	An impulse to strike and bite others + Delusions. Jealousy motivates the behaviors including the violent outburst Shameless /Exposes / Plays with his genitals . Increased sexual desire / Behaviors He imagines a queer kind of paper on the wall and he keeps imaging strange things about the figures.	Someone is going to poison them, so they avoid eating or drinking. His family members are keeping a watch over them all the time. Talks of imaginary things. Illusion of vermin, rats, mice in the room.	Unintelligible chattering can also appear. Silent: Picks up bed clothes; makes no complaints Laughing loudly at everything
Stram	Talk with Imaginary Spirits Visual hallucinations Religious insanity: Constant praying and Religious rhymes Grandiosity: Communication with God Raving mania: Active variable delirium + cold sweat Self accusation	Strange absurd ideas: Thinks himself tall, double Lying crosswise One half of body cut off Limbs feel separated from the body Laughs at night, weeps during day Fear / Anxiety on hearing water run Exposes the part. Stupid; imbecile; sits silent, eyes on ground, picking at her clothes; Wants to kill people or himself	Delusions: A firm belief that he is going to die soon. So prepares for his funeral. Delusions: Presence of multiple persons in room. He sees people coming out of all corners Hearing voices that scold him Delusion of faithless They are under the influence of these spirits	Disorganized speech Continuous talking Incomprehensible speech Loss of reason or speech Lascivious talk Violent speech: Maniac, Curses, Tears ones clothes with teeth Talking with others is intolerable Talks with imaginary People/ Spirits, which makes him restlessness.
Bar-c	Childish behavior He is being Talked About	They are being made fun of and people always laugh at them Difficulty in concentration and confusion of mind.	Other people are talking about them
Plat	Delusions Of Grandiosity
Phos		Over sensitiveness Depression	Grandiose delusion: Extra-gated idea of self-importance
Aur	Feeling of self condemnation and utter worthlessness Profound despondency, with Thoughts / Talks of suicide	Great fear of death Peevish and vehement at least contradiction Anthrophobia; mental derangements. Cannot do things fast enough Over sensitiveness to noise, excitement, confusion.		Constant rapid questioning without waiting for reply
Stage 2 remedies
Bell	Teeth grinding with inclination to bite others He strikes those around him. Hot head, cold Hands / Feet and finally pale as the stupor increases.	He fears imaginary things and wants to run away from all his attendants Patients loses his memory of all things and becomes wild Aversion Noise / Light and company Hydrophobia	He sees Ghosts Hideous faces Animals Insects	Patient breaks into fits of laughter or screams
Cupr	Delusions Of Grandiosity Delirium as a main theme of Cupr.	War theme: He feels he has to be prepared for a sudden attack and has to attack back. Not continuous but intermittent spasms Cough comes in attacks, anger comes in attacks. Children: Fear of being approached; Cannot bear anyone coming near her and reacts immediately by striking, shrieking, biting, spitting, rage, kicking, attacking with fists, etc.	Delusion of being an Officer/ Great person/ General. Finlay I will become insane They imitate others, sometimes making fun of others. There is also a certain degree of egotism. They can be good entertainers as well. Performance Selling vegetables Repairing old chairs	Maniacal, Malicious, Megalomania, Loquacity Anxiety, Cheerfulness, Convulsions Frequent pulse ,Increased perspiration He is afraid of approaching others and wants to run away. Agg with darkness His delirium is manic and accompanied by Talkativeness / Violence /Biting
Kali-br	Nervous/ Restless, Esp hands and fingers	Nervous/ Restless; Cannot sit still, must move about or keep occupied, Esp hands and fingers Depressed, low-spirited Ill-effects of worry, Esp illness of his family It could be the ill effects of lascivious fancies, satyriasis or nymphomania. Uncontrollable weeping attacks and profound melancholic delusions. Loss of memory; forgets how to talk; absent-minded; had to be told the word before he could speak it.		Delusion, he is watched / Persecuted Delusion he has committed a crime Delusion he is devil
Cann-i	Mood swings Strange/Unreal feeling Disorientation	Strange/Unreal feeling: The illusion of being weird even his own voice become strange He may be lost in familiar places due to forgetfulness and confusion They have out-of-body experiences therefore frightened. (Stram) Severe mood swings between suspicion and excitement Delusion enlarged distances or objects or time		Talkativeness + Identity Disorder (Verat) Fun, Laughing and ridiculous

Other remedies

Syph, Kreos, Ars, Merc, Med, Carc, Ph-ac, Nux-v, Agar, Pic-ac, Calc-p, Sul, Ign, Lyc