This research paper discusses schizophrenia in terms of history, symptom presentation, diagnostic criteria, and relevant differential diagnoses (DSM-IV). Recent research is presented regarding schizophrenia and its neurological/biological basis; this material is contrasted with Freud's psychodynamic theory in relation to schizophrenia. Relevant diagnostic tests for neurological/biological etiology and results are noted. Psychopharmacological management of schizophrenia with reference to risperidone is addressed.
Schizophrenia is a disorder that is characterized by signs and symptoms present for one month (active-phase symptoms), and lasts for at least six months. Active-phase symptoms include delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms (two or more). Subtypes include Paranoid, Disorganized, Catatonic, Undifferentiated, and Residual (DSM-IV, 1994, pp. 273-274).
Cultural factors are considered when assessing symptoms of schizophrenia. Linguistic variations in narrative styles may result in difficult assessment of disorganized speech. Emotional styles may vary across cultures. Behaviors have different meanings within each culture. Catatonic behavior is uncommon for individuals with schizophrenia in the United States; it is more common in non-Western countries. Developing nations, more than industrialized nations, tend to have schizophrenics with a more acute course and better outcome (DSM-IV, p. 281).
Onset is usually found to occur between late teens and mid-30s. Symptoms are the same for children, however diagnosis is difficult at early ages. Late-onset may occur; in this case there is a higher incidence of women, a better occupational history, and greater likelihood of being married. Paranoid delusions and hallucinations are more likely than disorganized and negative symptoms and course is usually chronic with response to lower doses of antipsyc...