Fast Five Quiz: What Do You Know About Schizophrenia?

Stephen Soreff, MD

Disclosures

August 09, 2019

Numerous patients with schizophrenia display obsessive-compulsive symptoms. Some antipsychotic medications, particularly clozapine, may cause such symptoms.

Where there are symptoms of organic brain impairment—difficulty in orientation to time, place, and person; difficulty with immediate, recent, and distant recall; difficulty providing concrete answers to proverbs—in addition to the above schizophrenia symptom domains of positive, negative, cognitive, and mood, a neurologic workup is indicated.  

Rarely, the symptoms of brain tumors may be confused with a psychotic illness. Because brain tumors are potentially fatal but treatable, brain imaging should be considered in any person with a new onset of a psychotic illness or, perhaps, a marked change in symptoms. Subdural hematomas may lead to changes in mental status. For patients who report head trauma or are unable to provide a clear history, intracranial bleeding should be considered. Idiopathic calcification of the basal ganglia infrequently presents as psychosis in patients who become symptomatic early in adulthood.

Contrary to the public perception of schizophrenia, most people with the disorder are not violent. A few may act violently, sometimes as a result of command hallucinations or delusions, and the resulting publicity adds to the stigma of the disease. An example of a command hallucination is when a patient hears voices telling him to kill others or himself. Schizophrenia is linked with both depression and anxiety. Anxiety may precede the diagnosis of schizophrenia by several years.

To learn more about the complications of schizophrenia, read here.

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