hotic medications (DSM-IV, p. 281).
Women are more likely to have later onset, prominent mood symptoms, and good prognosis. Community surveys suggest an equal sex ratio; broader definitions demonstrate higher female-to-male ratios. Early to mid-20s for men and late 20s for women are median ages at onset for first psychotic episodes. Biological relatives (first-degree) of those with schizophrenia are at an increased risk for the disorder (10 times). Environmental factors are also important. Factors associated with a more positive prognosis include good premorbid and interepisode adjustment, acute and later age onset, female, precipitating events, mood disturbance, brief active-phase, minimal residual symptoms, no structural brain abnormalities, and family history of Mood Disorder (DSM-IV, pp. 282-283).
Symptoms include a range of cognitive and emotional dysfunctions and fall into two categories, positive and negative. Positive symptoms include excess or distortion of normal functions. These are distortions of inferential thinking (delusions), perception (hallucinations), language or communication (disorganized speech), and behavioral monitoring (disorganized or catatonic). Negative symptoms show a loss of normal functions. These are restrictions in range and intensity of emotional expression (affective flattening), fluency and productivity of thought and speech (alogia), and initiation of behavior that is goal-directed (avolition) (DSM-IV, pp. 274-275). Whether onset is abrupt or insidious, most show a prodromal phase with slow and gradual development of signs and symptoms. Symptoms such as social withdrawal, loss of interest in activity, deteriorated hygiene, unusual behavior, or outbursts of anger may not by interpreted as more than a passing phase. Eventual active-phase symptoms more commonly lead to the consideration of schizophrenia. The course may vary, some may display exacerbations and remissions and others ...