A schizophrenic patient shows abnormal back and forth movements of hands, diagnosis -
Ans is 'a' i.e. Catatonic schizophrenia o Clinical subtypes of schizophrenia are:-1) Paranoid schizophrenia:- This is the commonest type of schizophrenia. The core symptoms are delusions of persecution, i.e., there are suspicious ideas and belief. Delusions of grandeur, reference, Control and double are also common as are the auditory hallucinations. There is minimal or no disturbances of affect volition, speech, motor behavior, and personality. The onset is in later life (3rd- 4th decade), in contrast to other subtypes. The prognosis is better than other subtypes (only catotonic schizophrenia has better prognosis better than paranoid). Amphetamine can cause paranoid schizophrenia like symptoms.2) Hebephrenic (Disorganized) schizophrenia:- It is the second most common type of schizophrenia. As evident from its name (disorganized), this type of schiophrenia is marked by disorganized thought, behavior, speech, affect, and personality with fragmentary and changeable delusions and hallucinations. This is one of the subtype where emotional impairment is prominent (e.g., flat or inappropriate affect). It has one of the worst prognosis as negative symptoms occur early (e.g., flat, blunted or inappropriate affect). This subtype starts early in 2nd decade.3) Catatonic schizophrenia:- It is characterized by a marked disturbance of motor behavior. It may occur in three forms:-a) Excited catatonia:- It is characterized by increased in psychomotor activity (restlessness, agitation, excitment, aggressiveness, violence) and increase in speech production (Pressure of speech). Psychomotor activity is purposeless and has not apparent relationship with external environment. The impulsive activity may occur in response to hallucinations and delusions. Reactive catatonia has the best prognosis.b) Stuporous (retarded) catatonia:- Characterized by extreme retardation of psychomotor function, which includes mutism, rigidity, negativism, posturing, echolalia, Echopraxia, Catalepsy (waxy flexibility), ambitendency, gegenhalten, Streotypies, stupor, Mannerism, Grimicing), Automatic obedience, and verbigeration.c) Catatonia alternating between excitment and stupor:- The features of both excited catatonia and stuporous catatonia are altematingly present.4) Undifferentiated schizophrenia:- This type meets the general diagnostic criteria for schizophrenia but symptoms do not meet the criteria for paranoid, catatonic, and disorganized schizophrenia.5) Residual schizophrenia:- This represents a chronic stage of schizophrenia with incomplete remissions and residual negative symptoms (lack of drive, shallow affect) with no or minimal recurrence of positive symptoms (i.e., Absence of delusions, hallucinations, disorganized speech, catatonic behavior).6) Simple schizophrenia:- Characterized by a slow and progressive withdrawal from the social and work situations. Except for lack of drive & initiative (due to withdrawal) and shallow emotions the patient does not exhibit any psychotic features (Hallucination or delusions are not present), i.e., there are only negative symptoms and no positive symptoms. In simple schizophrenia positive symptoms do not occur at any time during the course, in contrast to residual schizophrenia where positive symptoms occur initially but later on only residual negative symptoms remain to be present.7) Other:- In post-schizophrenic depression the depressive symptoms become florid as an outcome of schizophrenic illness and not as a reaction to it. Schizophrenia when occurs in the presence of mental retardation, is called pfropf schizophrenia. Von-Gogh syndrome is a dramatic self multilation in schizophrenia.
Catatonic schizophrenia
Paranoid schizophrenia
Disorganized schizophrenia
Undifferentiated schizophrenia
Schizophreniform Disorder