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Auditory Hallucinations and Religious Delusions
Published in Ragy R. Girgis, Gary Brucato, Jeffrey A. Lieberman, Understanding and Caring for People with Schizophrenia, 2020
Ragy R. Girgis, Gary Brucato, Jeffrey A. Lieberman
Catatonic schizophrenia is also quite severe. This subtype was far more common during the era before antipsychotic medications were in wide use. People whose symptoms meet criteria for this subtype demonstrate severe catatonia, which implies the maintenance of bizarre, peculiar postures for minutes, hours or even days at a time. Mutism is commonly observed in catatonic schizophrenia. Alternatively, such persons may show excessive, disinhibited, and purposeless motor activity, such as constantly walking or jumping around, or moving different parts of the body without clear direction. Catatonic schizophrenia may be especially responsive to intravenous benzodiazepines, such as lorazepam, or to electroconvulsive therapy (ECT).
The Efficacy And Safety Of Mmect – Patient Parameters
Published in Barry M. Maletzky, C. Conrad Carter, James L. Fling, Multiple-Monitored Electroconvulsive Therapy, 2019
Among the 42 schizophrenic patients treated with MMECT, outcome was not especially good, with 23, or more than half the sample, receiving global assessment ratings of less than 2.0. Moreover, even among schizophrenics who did improve, ratings were not as high as for the depressed patients who improved. The global rating for the 19 schizophrenic patients improving to a score greater than 2.0 was just 2.4, as compared to 3.42 for the equivalent figure among depressed patients. These average data, however, may obscure some progress significant for some subtypes of schizophrenia. Patients with schizoaffective and catatonic schizophrenia responded better than those with paranoid and chronic undifferentiated types. Thus, 12 of 17 schizoaffective patients and both catatonic patients received post-MMECT global assessments in excess of 2.0, as compared to just 1 of the 6 paranoid schizophrenics and 3 of the 9 chronic undifferentiated schizophrenics. This finding may give additional support to the recently posed hypothesis that catatonia may be as much a sign of an affective as a schizophrenic illness.19 These figures also correlate well with those for the effect of conventional ECT in schizophrenia, but must be regarded with some caution because of the uncertainty in assigning subtypes in many cases of this illness.
Questions and Answers
Published in David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly, MRCPsych Paper I One-Best-Item MCQs, 2017
David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly
Answer: D. Residual schizophrenia involves an absence of prominent delusions, hallucinations, disorganised speech or grossly disorganised or catatonic behaviour. There is continuing evidence of disturbance with negative symptoms or two or more positive symptoms present in attenuated form. In disorganised schizophrenia, disorganised speech, disorganised behaviour and a flat or inappropriate affect are prominent. Catatonic schizophrenia is characterised by at least two of the following: motor immobility, excessive motor activity, extreme negativism, peculiarities of voluntary movement, or echolalia or echopraxia. Paranoid schizophrenia involves a preoccupation with one or more delusions or frequent auditory hallucinations. In undifferentiated schizophrenia the patient meets the core criteria for schizophrenia but criteria for the other subtypes are not met. [AH. pp. 155–7]
Comparative study of effectiveness of augmentation with ECT in clozapine resistant schizophrenia (CRS) and non-clozapine resistant schizophrenia (Non-CRS)
Published in Nordic Journal of Psychiatry, 2021
Sandeep Grover, Anish Shouan, Subho Chakrabarti, Swapnajeet Sahoo, Aseem Mehra
Most (67.9%) of the participants were inpatients at the time of initiation of ECT. Majority were diagnosed with schizophrenia, with undifferentiated schizophrenia (48.5%) and paranoid (45.6%) being the common subtypes. Only a small proportion of the patients were diagnosed with catatonic schizophrenia (5.9%). The mean duration of illness at the time of starting of ECT was 121.6 months (SD: 104.1 months). Other clinical details of the study participants are given in Table 1. In the majority of the patients, ECT was given due to poor response to the medications and the majority of the participants had positive psychotic symptoms at the time of administration of ECT (Table 1). When those with and without CRS were compared, it was seen that compared to those without CRS, those with CRS had a significantly longer duration of illness and a significantly higher proportion of them had a past history of receiving ECT (Table 1).
Lunar cycle and psychiatric hospital admissions for schizophrenia: new findings from Henan province, China
Published in Chronobiology International, 2020
Ran-Ran Wang, Yu Hao, Hua Guo, Meng-Qi Wang, Ling Han, Ruo-Yun Zheng, Juan He, Zhi-Ren Wang
Schizophrenia is one of the most devastating of all mental illnesses and has a dimensional structure. We divided schizophrenia into three categories based on symptoms: characterized by positive syndrome (including paranoid schizophrenia, catatonic schizophrenia, and undifferentiated schizophrenia), characterized by negative syndrome, and unspecified schizophrenia (Kim et al. 2013; Nelson et al. 2015). It was necessary to classify schizophrenia according to positive and negative symptoms (Eisenstein et al. 2017; Gupta et al. 2014) as people with deficit schizophrenia subtypes show different risk factors, biological correlates, treatment response, and illness course than those with paranoid schizophrenia (Kirkpatrick et al. 2008). Furthermore, an association between schizophrenia and specific genes such as IFN-gamma (+874A/T), TNFR2, and TNF-alpha/beta has been confirmed only for the paranoid form, not for the other subtypes (Inoubli et al. 2018; Jemli et al. 2017; Suchanek-Raif et al. 2018), although few studies have included stratification of clinical features.
Electroconvulsive therapy combined with antipsychotic therapy in the treatment of acute schizophrenia inpatients: symptom profile of the clinical response
Published in Psychiatry and Clinical Psychopharmacology, 2018
Derya Ipekcioglu, Menekse Sıla Yazar, Ozge Canbek, Ozge Yuksel, Kumru Senyasar Meterelliyoz, Mehmet Cem Ilnem
Among studies on symptom profiles, Zervas et al. reported that the best responses to ECT were found for catatonic, paranoid, and affective symptoms [28]. Thırthallı et al. reported that patients with catatonic schizophrenia had a faster response to ECT [9]. There are studies reporting that ECT is effective for catatonia, anxiety, treatment incompatibilities, auditory hallucinations, persecution delusions, agitation, anorexia, and aggressive behaviour, yet ineffective for somatic complaints and negative symptoms [29]. Johns et al. have stated that ECT improves affective symptoms in schizophrenia patients and has no effect on delusions, hallucinations, and thought disorder [30]. It is remarkable in our study that ECT combined with AP therapy was effective for treating both positive symptoms and negative symptoms in the acute phase. Positive symptoms, such as hallucinations and positive formal thought disorder, and negative symptoms, such as affective flattening or blunting, were the most rapidly improved symptoms. Reports differ regarding the effects of ECT administered in addition to antipsychotic therapy in schizophrenia patients. This difference may be due to differences in sample size, sampling characteristics (gender, race, disease period, etc.), the type of antipsychotic used, and ECT method (such as unilateral or bilateral). Studies on the effectiveness of ECT in schizophrenia were mostly performed with treatment-resistant schizophrenia patients, and the literature on symptom profiles is limited.