A rapidly growing psychotic disorder, Schizophrenia, has the most severe impact on people's lives & health care system. Though a small percentage of people had been diagnosed, the seriousness & incapacitating consequences of schizophrenia mean that about 50% of affected will become severely & permanently disabled & dependent on public assistance. As DSM-IV-TR, schizophrenia probably includes several disorders with different causes that are currently lumped together because there is not enough knowledge of the critical factors that differentiates them. Current classification & subtypes are as follows.
1. Paranoid type - Preoccupation with delusions or auditory hallucinations. Little of no disorganized speech, disorganized or catatonic behavior, inappropriate or flat affect.
2. Disorganized type - All the following - disorganized speech, disorganized behavior, inappropriate or flat affect - are prominent in behavior but catatonic - type criteria are not met. Delusions or hallucinations may be oresent, bit only in fragmentary or noncoherent form.
3. Catatonic type - At least two of following - extreme motor immobility, purposeless excessive motor activity, extreme negativism or mutism, peculiar or bizarre voluntary movement ; echolalia or echopraxia.
4. Undifferentiated type - Does not fit in any of the subtypes above, but meets the symptom criteria of schizophrenia.
5. Residual type - Has experienced at least one episode of schizophrenia, but does not have currently prominent positive symptoms like delusions, hallucinations, disorganized speech or behavior. However, continues to show negative symptoms & a milder variation of positive symptoms like odd beliefs, eccentric behavior etc.
Antipsychotic medications are the mainstay of treatment for schizophrenia & reflect the importance of biological perspective in understanding and treating this disorder. However, at the same time, there is considerable evidence that psychosocial interventions with these medications, especially after the first acute episode of disorder, are very helpful in preventing relapse & improving social functioning.
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