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TYPES OF SCHIZOPHRENIA
1. SIMPLE
Gradual loss of interest in the surroundings
Withdraw himself from reality, fantasy

2. HEBEPHRENIC
Hallucinations & delusions prominent
Meaningless giggles & self satisfied smile

3. CATATONIC
In adults
Out burst of excitement, depression, stupor
Disturbance of behavior & motor phenomena
Homicidal & suicidal tendencies

4.PARANOID
Females
Late stage
Delusion of persecution
Hypochondriacally delusions
Well preserved personality

5.OTHERS
Schizoaffective – associated symptoms of mania & depression
Pseudo neurotic – features of neurotic illness like hysteria, phobic syndrome etc.
Periodic catatonia – a correlation between onset & metabolic disturbances
Late praphrenia – Females & widows
Delusion of persecution & hallucinations
Oneiroid schizophrenia – acute onset, clouding of consciousness, disorientation
Dream like state & perceptual disturbances.  

PROGNOSIS
15-20 % Complete recovery

FACTORS TO BE CONSIDERED
Onset –a/c good prognosis
Type-Paranoid and Catatonic-good prognosis
Precipitating factor-bad
Age-early-bad
Personality-well adjusted and stable- good
Duration shorter good
Family history positive – bad
Personal relation ship – warm good
Home relation ship warm – good
Mood- disturbed – bad
Treatment prompt – good

TREATMENT
Drugs
Psychological treatment
Reassurance
Moral support
Good patient relation ship
Environmental and social background

PARANOID PSYCHOSIS
Defined as
- Gross impairment of reality thinking
- Marked impairment in personality with impairment in social, interpersonal and occupational functioning
- Marked impairment in judgment and behavior
- Having delusions & hallucinations
Non organic - Schizophrenia & mood disorders
Organic _ paranoid disorders  

PARANOID SCIZOPHRENIA
Is characterized by
Delusions of persecution
Delusions of reference
Delusions of grandeur
Delusions of jealousy
Schneidors first rank symptoms.
Well systematized delusions
Apprehensive , evasive and guarded.
Onset insidious, progressive course, no recovery, remission and relapses.

DIFFERENTIAL DIAGNOSIS
Paranoid disorder
Paranoid personality disorder.

PARANOID DISORDER (DELUSION DISORDER)  
Persistent delusion of persecution, grandeur, jealousy, etc
Absence of significant or persistent hallucination.
Personality disorder only in areas of delusion.
No underlying cause.
Absence of schizophrenic and mood disorders.
Depending on the content of delusions.
1.Acute Paranoid disorder.
Having an acute onset and good prognosis,6 months duration.
Common etiology in abrupt change in environment.                   
2. Paranoia
A disorder with an insidious onset, stable and chronic course, characterized by well-systematized delusions.
Eccentrics, suspiciousness, reduced social interaction.
Disturbed in delusional areas, normal in other areas.
Well systematized delusions; no other thought disorder.
Hallucinations are uncommon; insight absent.
Contact with reality disturbed in delusional areas.
3. Shared paranoid disorder.        
Transfer of delusions from one person to another who is usually depend on the first person and in highly suggestible. both having knit emotional bond, on separation they give up delusions.
4.Paranoid personality disorder.
Restrained social interaction, no deterioration of personality no thought disorder, or hallucination. Insight present. Contact with reality present.

DIFFERENTIAL DIAGNOSIS.
Paranoid schizophrenia
mania
depression
personality disorder and
organic delusional disorder

TREATMENT
Drugs
Supportive psychotherapy.

MANIAC DEPRESSIVE PSYCHOSIS
An affective disorder
If the affect remain depressed or sad the resulting illness - MDP depression
If the affect remain happy or elated the resulting illness - MDP depression
Thus mania and depression are the two phases of MDP
 Cyclic : When depression and mania alternate with symptom free interval
Circular : When one phase of depression directly leads to mania or vice versa

ETIOLOGY
-  A dominant inheritance
- Having cycloid temperament – rapid change of mood without any cause
- Jewish ,Females
- Physical illness like arteriosclerosis ,head injury, neurosyphilis & hypothyroidism
May lead to depression
Drugs as reserpine
Deficiency of dopamines & amines as seratonine and residual sodium increase by 50%
MDP MANIA

Symptomatology
Elation
Well dressed, cheerful, entertaining and highly interfering
Having euphoria & excitement
Speech : Over talkative, coherent, rate of talk is high. Flight of ideas, grandious or persecutory delusions in talk
Disorders of perception _ illusion
Get up early, and engage in various unwanted activities which are left uncompleted
Unreasonably interfering with affairs of other people
Turn violent, aggressive, destructive and uncontrollable
Drug addiction and intoxication
Apparent impairment of memory, lack of insight & judgment

DIAGNOSIS
From clinical features
Elation ,increased psychomotor activity
Presence of talk, flight of ideas & grandiose delusions
D/D
Schizophrenia
GPI
Phenobarbitone poisoning
Alcoholic excitement & delirium

COURSE
Self limiting course
Recurrence may occur

TREATMENT
Drugs
ECT  

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