Questions and Answers
David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly in MRCPsych Paper I One-Best-Item MCQs, 2017
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]
100 MCQs from Dr. Brenda Wright and Colleagues
David Browne, Selena Morgan Pillay, Guy Molyneaux, Brenda Wright, Bangaru Raju, Ijaz Hussein, Mohamed Ali Ahmed, Michael Reilly in MCQs for the New MRCPsych Paper A, 2017
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, of echolalia or echopraxia. Paranoid schizophrenia involves a preoccupation with one or more delusions or frequent auditory hallucinations. Undifferentiated schizophrenia meets the core criteria for schizophrenia but criteria for the other subtypes are not met. (4, pp 155–7)
The Efficacy And Safety Of Mmect – Patient Parameters
Barry M. Maletzky, C. Conrad Carter, James L. Fling in 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.
Catatonia Related to Cannabis and Synthetic Cannabinoids: A Review
Published in Journal of Dual Diagnosis, 2021
Raul Felipe Palma-Álvarez, Albert Soriano-Dia, Elena Ros-Cucurull, Constanza Daigre, Pedro Serrano-Pérez, Germán Ortega-Hernández, Marta Perea-Ortueta, David Gurrea Salas, Josep-Antoni Ramos-Quiroga, Lara Grau-López
Interestingly, psychomotor symptoms induced by cannabis are usually neglected, specifically catatonia-like symptoms. Catatonia is a complex syndrome with several psychomotor manifestations which has traditionally been considered as part of the schizophrenia spectrum (Solmi et al., 2018; Walther et al., 2019). The conception of catatonia was substantially changed in the DSM-5 and the last version of International Statistical Classification of Diseases and Related Health Problems (11th ed.; ICD-11; APA, 2013; Solmi et al., 2018; Tandon et al., 2013; WHO, 2019). These changes have emerged after a progressive but incessant investigation since the 70 s (Solmi et al., 2018; Tandon et al., 2013). In these investigations, it was found catatonia may be present in several medical conditions and many psychiatric illnesses (interestingly, more frequent in bipolar and mood disorder than schizophrenia; APA, 2013; Solmi et al., 2018; Walther et al., 2019; WHO, 2019). Thus, catatonia has assumed the status of an independent syndrome in the ICD-11 aside from schizophrenia (which may be present in many medical and mental conditions) and the status of a specifier in several medical and specific mental disorders in DSM-5 (see Table 1; APA, 2013; Reed et al., 2019; Tandon et al., 2013; WHO, 2019). In both classifications, there is a residual category of catatonia not otherwise specified (Reed et al., 2019; Tandon et al., 2013).
“Spice Was Made, by the Devil Himself”: A Thematic Analysis of the Experience of an Addiction to Synthetic Cannabinoids
Published in Journal of Psychoactive Drugs, 2023
Blessing N. Marandure, Samson Mhizha, Amanda Wilson
In assessing SC effects, it is not always clear which symptoms are acute and directly linked with intoxication, and which may persist after cessation. Additionally, isolating long-term effects of SCs is confounded by the poly-drug context in which they are often used. Nevertheless, two potential effects that may persist following SC use are psychosis and cognitive impairment. SCs have been linked to both new onset psychosis, and relapse in previously diagnosed individuals (Deng et al. 2018; Fattore 2016; Yeruva et al. 2019). Psychotic symptoms identified include alterations in perception, paranoia, catatonia, depersonalization, dissociation, auditory and visual hallucinations (Papanti et al. 2014; Yeruva et al. 2019). In most cases, symptoms disappear following cessation (Deng et al. 2018; Peglow, Buchner, and Briscoe 2012), though they may persist and in other cases even lead to diagnosis of a psychotic disorder (Papanti et al. 2013; Yeruva et al. 2019). Comparisons with cannabis show more psychotic symptoms in SC users (e.g. Bassir Nia et al. 2016), most likely due to the significantly higher potency of SCs (Cohen and Weinstein 2018; Darke et al. 2021).
Severe clinical events in 100 patients with schizophrenia: a retrospective clinical description using a system-specific psychopathological approach
Published in Nordic Journal of Psychiatry, 2018
Moritz E. Wigand, Fabian U. Lang, Lea Reichhardt, Thomas G. Schulze, Sebastian Walther, Thomas Becker, Markus Jäger
Schizophrenia is known to be associated with social decline and social stagnation [4], but there is no gold standard to measure social functioning in schizophrenia [5,6]. Catatonic states, which have long been described clinically but not diagnosed in an operationalized way [7,8], are a component of schizophrenia in a subgroup of patients. In an Indian study on inpatients, Grover et al. found a prevalence of catatonia of 10.5% in the schizophrenia subgroup (n = 67) [9]. Although van der Heijden et al. found evidence for a decrease in the diagnosis of catatonic schizophrenia, this decrease might actually be related to changes in diagnostic criteria and to a rater bias in favour of paranoid symptoms and may not represent an actual decline of catatonias [10]. Catatonic states such as catatonic stupor and excitement can turn malignant with increased mortality [8], which calls for more research in this field.
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