Esquizofrenia y trastornos psicóticos (I-II)

Esquizofrenia y otros trastornos psicóticos (I-II). Catatonia

• Morel (1860) described "démence précoce" , a form of early-onset dementia, characterized by intellectual deterioration and onset during adolescence.
• Key features of early stages include social withdrawal (sometimes called autism, meaning a form of self-imposed isolation in this context), strange mannerisms with no clear purpose, and a neglect of self-care.
• Final stages are characterized by intellectual deterioration similar to later-onset dementia, hence the name "early-onset dementia".
• Kahlbaum (1863) described catatonia, a motor disorder found in various forms of psychosis including schizophrenia.
• Hecker (1871) identified hebephrenia, a severe form of schizophrenia characterized by primitive, child-like behavior.
• Kraepelin (1893) further defined schizophrenia, separating it from manic-depressive psychosis and other forms, and identifying subtypes such as paranoid, hebephrenic, and catatonic.
• Kasanin (1933) described schizoaffective disorder, a condition with both psychotic and mood/affective symptoms (depression, mania).
• Langfeldt (1939) emphasized the difficulty of diagnosis in early-onset psychoses, noting that it often takes time to distinguish it from bipolar disorder.
• Schneider (1950) categorized the symptoms into first-rank and second-rank symptoms, emphasizing the specific characteristics to diagnose schizophrenia.
• Andreasen (1983) differentiated positive and negative symptoms, with positive symptoms (hallucinations, delusions) representing unusual cognitive processes and negative symptoms (flat affect, social withdrawal) representing a decrease in healthy functioning.
• Kay (1991) proposed an integrated model of schizophrenia classification based on four groups of symptoms (positive, negative, affective, and excitement/disorder), each independent of the other.
• Crow (1980) distinguished two types of schizophrenia: type I (more easily treatable, onset after 25, less genetic impact) and type II (more severe, more genetically influenced, and often has onset before 25).

Epidemiology of Schizophrenia

• Schizophrenia usually appears in late adolescence or early adulthood.

Etiology of Schizophrenia

• Genetic factors are estimated to account for 80% of the risk of developing schizophrenia.
• Several other non-genetic factors have been identified including complications during pregnancy, environmental influences, and the use of drugs.

Clinical Forms of Schizophrenia

• Paranoid: Predominantly positive symptoms, like delusions and hallucinations, with relatively preserved affect.
• Disorganized (Hebephrenic): Characterized by disorganized thinking, flat or inappropriate affect, and bizarre behaviors; often has a poor or poor prognosis.
• Catatonic: Marked psychomotor disturbance, such as stupor, excitement, posturing, and echopraxia.
• Undifferentiated/Residual: Symptoms do not fit the criteria for any other subtype, or symptoms indicative of a past schizophrenia episode present.
• Simple: Gradual onset of negative symptoms and deterioration in functioning, with a lack of prominent positive symptoms.

Schizoaffective Disorder

• Characterized by a combination of psychotic symptoms and mood disorders (e.g., depression or mania).

Schizotypal Disorder

• A personality disorder characterized by unusual and inappropriate behaviors and thoughts and discomfort in interpersonal relationships.

Brief Psychotic Disorder

• A brief, temporary psychotic episode that emerges within weeks and resolves within a month; it often has clear triggers.

Delusional Disorder

• Presence of one or more delusions (fixed false beliefs), which persist for a considerable duration. Affective and cognitive functions are mostly spared.

Conclusion

• Treatment for schizophrenia involves both biological and psychosocial methods,
• Comorbidities (co-existing conditions) are common in schizophrenia, particularly mood disorders (e.g., depression), anxiety, and substance use.
• Diagnosis and treatment of schizophrenia are complex and often require a multidisciplinary team approach.

Este cuestionario explora la esquizofrenia y otros trastornos psicóticos, centrándose en la catatonia y sus características. Se aborda la evolución histórica de estas condiciones, desde la descripción de 'démence précoce' hasta las especificaciones de Kraepelin. A través de preguntas basadas en estas nociones, se busca profundizar en la comprensión de estos trastornos mentales.