F20.0 | Paranoid schizophrenia | Thorazine, Haldol, and Risperdal | This is the commonest type of schizophrenia in most parts of the world. The clinical picture is dominated by relatively stable, often paranoid, delusions, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances. Disturbances of affect, volition, and speech, and catatonic symptoms, are not prominent. Examples of the most common paranoid symptoms are:(a) delusions of persecution, reference, exalted birth, special mission, bodily change, or jealousy; (b) hallucinatory voices that threaten the patient or give commands, or auditory hallucinations without verbal form, such as whistling, humming, or laughing; (c) hallucinations of smell or taste, or of sexual or other bodily sensations; visual hallucinations may occur but are rarely predominant.Thought disorder may be obvious in acute states, but if so it does not prevent the typical delusions or hallulcinations from being described clearly. Affect is usually less blunted than in other varieties of schizophrenia, but a minor degree of incongruity is common, as are mood disturbances such as irritability, sudden anger, fearfulness, and suspicion. "Negative" symptoms such as blunting of affect and impaired volition are often present but do not dominate the clinical picture.The course of paranoid schizophrenia may be episodic, with partial or complete remissions, or chronic. In chronic cases, the florid symptoms persist over years and it is difficult to distinguish discrete episodes. The onset tends to be later than in the hebephrenic and catatonic forms. |
F20.1 | Hebephrenic schizophrenia | olanzapine, risperidone, and clozapine | A form of schizophrenia in which affective changes are prominent, delusions and hallucinations fleeting and fragmentary, behaviour irresponsible and unpredictable, and mannerisms common. The mood is shallow and inappropirate and often accompanied by giggling or self-satisfied, self-absorbed smiling, or by a lofty manner, grimaces, mannerisms, pranks, hypochondriacal complaints, and reiterated phrases. Thought is disorganized and speech rambling and incoherent. There is a tendency to remain solitary, and behaviour seems empty of purpose and feeling. This form of schizphrenia usually starts between the ages of 15 and 25 years and tends to have a poor prognosis because of the rapid development of "negative" symptoms, particularly flattening of affect and loss of volition. |
F20.4 | Post-schizophrenic depression | A depressive episode, which may be prolonged, arising in the aftermath of a schizophrenic illness. Some schizophrenic symptoms must still be present but no longer dominate the clinical picture. These persisting schizophrenic symptoms may be "positive" or "negative", though the latter are more common. It is uncertain, and immaterial to the diagnosis, to what extent the depressive symptoms have merely been uncovered by the resolution of earlier psychotic symptoms (rather than being a new development) or are an intrinsic part of schizophrenia rather than a psychological reaction to it. They are rarely sufficiently severe or extensive to meet criteria for a severe depressive episode, and it is often difficult to decide which of the patient's symptoms are due to depression and which to neuroleptic medication or to the impaired volition and affective flattening of schizophrenia itself. This depressive disorder is associated with an increased risk of suicide. | |
F20.6 | Simple schizophrenia | An uncommon disorder in which there is an insidious but progressive development of oddities of conduct, inability to meet the demands of society, and decline in total performance. Delusions and hallucinations are not evident, and the disorder is less obviously psychotic than the hebephrenic, paranoid, and catatonic subtypes of schizophrenia. The characteristic "negative" features of residual schizophrenia (e.g. blunting of affect, loss of volition) develop without being preceded by any overt psychotic symptoms. With increasing social impoverishment, vagrancy may ensue and the individual may then become self-absorbed, idle, and aimless. | |
F21 | Schizotypal disorder | A disorder characterized by eccentric behaviour and anomalies of thinking and affect which resemble those seen in schizophrenia, thought no definite and characteristic schizophrenic anomalies have occurred at any stage. There is no dominant or typical disturbance, but any of the following may be present: |
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F22.0 | Delusional disorder | Criterion A: One or more nonbizarre (ie, involving situations that could occur in real life) delusion(s) is present for at least 1 month. Criterion B: Criterion A for schizophrenia has never been met. (Auditory and visual hallucinations may be present but are not prominent, while tactile and olfactory hallucinations often are present if related to the delusional theme.) Criterion C: Apart from the impact of the delusion, functioning is not impaired markedly, and behavior is not obviously bizarre. Criterion D: Mood episodes that may have occurred are relatively brief relative to the delusional periods. Criterion E: The disturbance is not due to the direct effects of a substance or a general medical condition. Subtypes are defined, including erotomanic, grandiose, jealous, persecutory, somatic, mixed, and unspecified. |
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F22.8 | Paranoia querulans |
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F23.9 | Acute and transient psychotic disorder, unspecified |