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Subtypes of Schizophrenia Catatonic schizophrenia
In this subtype of schizophrenia there is involvement of the muscular system either in the sense of hypermobility (excess muscle activity) or else in the sense of hypomobility (lack of muscle activity). With the immobility presentation the patient may present with bizarre postures. Often associated with this is an echolalia, where the patient repeats like a parrot a word or phrase that another person just spoke. Another symptom is common with catatonic schizophrenia, namely echopraxia, where movements of another person are imitated repetitively. There are dangers of malnutrition and self-inflicted injury. During an extreme excitement there is a danger of selfharm or a danger that the person in this state might harm others. Undifferentiated SchizophreniaIf all the criteria for schizophrenia as mentioned above are met, but none of the subtypes mentioned above, then the psychiatrist diagnoses this subtype of schizophrenia. This type seems to not be as responsive to treatment as for instance paranoid schizophrenia. Residual type schizophrenia: In this type of schizophrenia there has been a major episode of schizophrenia before, but the symptoms do not display psychotic features (like delusions, hallucinations, disorganized behavior or speech). However, there are other symptoms of schizophrenia present. This clinical entity is important to recognize as it can either lead to a complete remission (meaning "temporary cure") or else it can indicate an impending full-blown episode. In the latter case it is like the silence before the thunderstorm. The third alternative is that it stays for many years in a more stable fashion. Schizophreniform disorderIn this disorder the patient has symptoms of schizophrenia, but the duration is shorter than the 6 months requirement for schizophrenia. On the other hand the duration is longer than 1 month, below which it would be labeled "brief psychotic disorder". This diagnosis is either made in retrospect when the patient has recovered and the overall duration of he illness is known. Or it is a "provisional" diagnosis assuming that it will not last longer than 6 months(or 1 month with treatment). It is much less prevalent than schizophrenia with a lifetime prevalence of 0.2%. About 1/3 of patients recover in less than 6 months and are cured. The remaining 2/3 of patients progress either to schizophrenia or to schizoaffective disorder (Ref.2) References: 1. Dr. David Burns: "Feeling good --The new mood therapy", Avon Books, New York,1992. 2. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV),American Psychiatric Association, Washington,DC,1994. 3. Dr. Shaila Misri at the 46th St. Paul's Hosp. Cont. Educ. Conference, November 2000, Vancouver/B.C./ Canada. 4. JM Loftis et al. J Neurochem 2000 Nov 75(5): 2040-2050. 5. B. Zilbergeld et al. "Hypnosis - Questions& Answers", W.W. Norton & Co, New York,1986: 307-312. 6. MH Erickson & EL Rossi:"Hypnotherapy, an exploratory casebook", Irvington Publishers Inc., New York, 1979: chapter 8, 314-363. 7. G Steketee et al. Compr Psychiatry 2001 Jan 42(1): 76-86. 8. DS Mennin et al. J Anxiety Disord 2000 July-Aug 14(4): 325- 343. 9. J Hartland: "Medical &Dental Hypnosis and its Clinical Applications", 2nd edition, Bailliere Tindall,London,1982, page: 326-336.
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