Ainerhpozihcs!

Just a note.
The key: Signs and symptoms, duration, impaired functioning.

DSM-IV
A. Active Phase - 2 or more of the following (1 month duration)

1. delusions*
   
2. hallucinations*
   
3. disorganized speech (eg. loosening of association)
   
4. grossly disorganized or catatonic behavior
   
5. negative symptoms (The As: Affect flat, Alogia, Avolition, Anhedonia)
   

*only 1 symptom is required if delusions are bizarre (eg. "I am Allah")
or hallucinations - running commentaries(betul ke solat macam tu?)/3rd person (dia tu gila)

B. Social/occupatinal dysfunction

C. 6 months duration of continuous signs of disturbance including 1 month of active phase

D. Exclude schizoaffective + mood disorders

E. Exclude substance/GMC (general medical condition)

F. If the patient has a history of pervasive developmental disorder, there must be prominent delusions/hallucinations for at least 1 month for additional diagnosis of Schizophrenia.

Schizophrenic patients are INTELLIGENT people!
Some people are unfortunate. They develop this chronic and debilitating disease bit by bit.

Prodromal symptoms (decrease function in important areas, new interest) →Active Phase → Residual Phase (develop negative symptoms)

These are symptoms which are suggestive of Schizophrenia besides other psychotic disorders that we could think of. The First Rank Schneiderians Symptoms:

③auditory hallucinations (Have u heard voices that others don't hear?)
- running commentary
- 3rd person
- thought echo (own thought spoken loud)

④passivity phenomenon (Ever been controlled by some force or external power?)
- made feelings
- made actions
- made impulse
- somatic passivity (feels current in the brain, gastric churning)

③thought possession
- Thought withdrawal
- Thought insertion
- Thought broadcasting

① delusional perception
- reference
- persecutory (Is anybody against you?)
etc.

Preferably, ask using 'how', 'why', simply said the open ended type of questions. It gives a better and wider space for the patient to reveal their hidden symptoms. And of course, be patient :)

The Mental Status Exam (MSE)
Appearance: Dishaveled
Speech: Disorganized at times. But normal volume and tone. It varies I guess. Huhu.
Emotion: Flat affect, incongruent to thoughts
Perception: Auditory hallucinations
Thoughts: Persecutory delusion, delusion of reference, a patient of mine had suicidal ideation
Insight: Poor/Good, the patients I've met here usually were lack of insight
Cognition: Abstract thinking intact

(This isn't a generalisation, it's just a description to remember a patient with this disease)

Every patient is unique in his/her own way :)

Schizophrenia
by
DropDeadSleeping

She lay red with puffy cheeks.
Two shot guns at her feet.
Shaking her head.
They dance around like little puppets,
mocking her every sin.
Wishing she were dead.
Taunting her every move,
Watching her every mistake.
It was all fake.
Telling her to kill
Or even take a pill.
Popping X,
Just a temporary game.
So unfairly played.

Ya Allah ya Tuhan Kami, hanya Engkaulah yang menghilangkan kesedihan, Engkaulah yang Maha Menyembuhkan, tidak ada yang mampu menyembuhkan kecuali hanya Engkau yang menyembuhkan, sembuh tanpa terasa sakit...