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Schizophrenia
Published in Charles Theisler, Adjuvant Medical Care, 2023
Schizophrenia, formerly known as dementia praecox, is a chronic severe mental disorder characterized by significant alterations in perception, thoughts, mood, and behavior. The disorder affects how a person feels, thinks, and perceives reality (e.g., delusions, false beliefs, hallucinations, impaired cognitive ability, unclear or confused thinking, or hearing voices that do not exist). As a result, schizophrenia is characterized by behavioral problems, flat affect, trouble focusing or learning, and difficulty relating to others. Individuals with schizophrenia seem to have lost touch with reality. There is no cure for schizophrenia. Managing symptoms is the best way of managing the illness.
The Family and Invalidation
Published in R. D. Laing, The Politics of the Family, 2018
Here is an account by Professor Morel, a French psychiatrist, of his intervention into a family, from his textbook of psychiatry, published 1860. It is of historical interest for the introduction of the term dementia praecox, a term still in use though generally superseded by the notion of ‘schizophrenia’.
Definition
Published in Alan Weiss, The Electroconvulsive Therapy Workbook, 2018
It is believed that the brain's control of the seizure may be what makes ECT efficacious (Abrams, 2002). Seizure induction as a treatment for psychiatric illness was based upon early observations that symptoms of dementia praecox (schizophrenia) were diminished when patients developed epilepsy and that patients with epilepsy had a low incidence of psychosis (Mankad, Beyer, Weiner and Krystal, 2010).
Treatment of post-psychotic depression in first-episode psychosis. A systematic review
Published in Nordic Journal of Psychiatry, 2023
Isabel Bodoano Sánchez, Alba Mata Agudo, Margarita Guerrero-Jiménez, Braulio Girela Serrano, Paula Álvarez Gil, Carmen Maura Carrillo de Albornoz Calahorro, Luis Gutiérrez-Rojas
Depression in schizophrenia has historically been approached as intrinsic to the disorder itself much like positive and negative symptoms. Kraepelin distinguished between dementia praecox and manic-depressive illness but still included depression as a symptom present in the onset of dementia praecox [4]. Eugen Bleuler would include depression as one of schizophrenia’s secondary symptoms alongside hallucinations and delusions [5]. However, over the last twenty years, there has been a change in the approach to depression in schizophrenia. Depressive symptoms are seen not as part of the normal course of schizophrenia but as a comorbidity of this disorder. ICD-10 [6] has a specific diagnostic called ‘post-schizophrenic depression’ (F.20.4) that must occur within 12 months after the psychotic episode whilst psychotic symptoms are still present but are not predominant. On the other hand, DSM-IV [7] includes PPD in its appendix B as ‘postpsychotic depressive disorder of schizophrenia’ as a major depressive episode during the residual phase of schizophrenia whilst the diagnosis was removed from DSM-5 [8]. These manuals do not distinguish depression after a FEP from depression in chronic schizophrenia.
Conceptual and historical evolution of psychiatric nosology
Published in International Review of Psychiatry, 2021
Following the popularity of Kraepelin’s classification, many of his successor psychiatrists retained his diagnostic categories, but conceptualized them as syndromic entities without an underlying common longitudinal course. For instance, Bleuler (1911) transformed Kraepelin’s proto-disease entity of dementia praecox into the syndrome of the ‘group of schizophrenias’ (Pichot, 1994). Bleuler did so by emphasizing what Kraepelin had described as ‘the peculiar disturbance of the inner psychic association’ rather than the course of illness and the dementing processes. Kurt Schneider (1950) divided psychiatry broadly into ‘disease’ and ‘abnormal variations’, the former containing organic psychoses and endogenous psychoses (schizophrenia and manic-depressive psychoses, whose biological origin was unknown but postulated), and the latter containing personality disorders and reactions to experiences, with both domains requiring distinct approaches to classification (Schneider, 1950). The seeds of Schneider’s distinction were present in Kraepelin’s nosology as well since Kraepelin accepted the possibility of ‘psychogenic’ aetiology for some disorders and recognized that disorders could pass over ‘without sharp boundary into the domain of personal predisposition’ (Kraepelin, 1921).
Testing the difference between bipolar disorder and schizophrenia on the basis of the severity of symptoms with C(α) test
Published in Journal of Applied Statistics, 2019
Alka Sabharwal, Gurprit Grover, Sakshi Kaushik
Since centuries there has been an uncertainty regarding the separation of bipolar disorder and schizophrenia as they share some key symptoms which often create confusion and lead to misdiagnosis, especially on initial presentation, further resulting in ineffective treatment and worsening of outcome [7]. In 1896, Kraepelin repudiated the unitary hypothesis [4] and conceptualized the separation of dementia praecox (later renamed as Schizophrenia) from manic-depressive insanity (later renamed as Bipolar Disorder), which shared many similar symptoms [18]. This dichotomy still continues today in the nosological classes of schizophrenia and bipolar disorders [9]. The symptoms of schizophrenia can be classified into three independent domains: positive, negative and disorganized [18]. Bipolar disorder, on the other hand, is an affective disorder characterized by alternating periods of mania and depression [12]. Cognitive, psychosis, neurovegetative and negative symptoms are common to both the disorders with different degrees of severity. Although bipolar disorder can be indistinguishable from schizophrenia, yet, course of illness is a primary factor of distinction between them [18].