The Undifferentiated schizophrenia Is one of the five subtypes of schizophrenia that have been described today. Specifically, this diagnostic entity is performed by discarding.
That is, subjects with undifferentiated schizophrenia are those who do not meet the requirements to be diagnosed of any of the remaining four subtypes of the pathology.
Although it is a particular subtype of the disease, undifferentiated schizophrenia shares many pathogens with the rest of the subtypes and, therefore, constitutes a very serious and deteriorating pathology.
The schizophrenia Is a severe and chronic psychiatric disorder that affects approximately 1% of the population. Although the most prototypical symptoms of this pathology are psychotic (delusions and hallucinations), schizophrenia can present a variety of manifestations.
For this reason, at present they have been established Different types of schizophrenia , Which depend largely on the clinical presentation of the subject.
Characteristics of undifferentiated schizophrenia
Undifferentiated schizophrenia is a neurodevelopmental disease that involves the presence of a wide variety of symptoms and manifestations.
It is classified as a psychotic disorder and presents a chronic course that usually deteriorates in a high way the functioning and the quality of life Of the individual who suffers.
The general characteristics of the disorder are a mixture of peculiar signs and symptoms (both positive and negative) that have been present a significant part of time during a minimum period of one month.
Also, some signs of the disease must have persisted for at least six months in order to be able to diagnose undifferentiated schizophrenia.
The symptomatology of the disorder causes a marked dysfunction or deterioration in the social or work environment of the person. Likewise, the alteration suffered is not caused by the direct effects of a medical illness or the Consumption of psychoactive substances .
symptom
Schizophrenia is a complex disorder that can encompass a large number of different symptoms and manifestations.
It is a serious and chronic disorder that causes a suicide rate of 10% and requires at least one hospitalization in more than 50% of cases. Likewise, the disease is subject to high emotional and economic erosion, and is highly stigmatized in today's society.
On the other hand, schizophrenia is characterized by not having a unique and specific clinical picture, so that the symptomatology may vary in each case.
For this reason, five subtypes of schizophrenia have been postulated ( Paranoid , Disorganized, catatonic, undifferentiated and residual). However, the clinical presentation of these subtypes, although more specific, also tends to vary in each case.
In this sense, several authors postulate the division of the symptomatology of schizophrenia into five main dimensions:
1- Positive symptoms
They are the most typical of the disease and encompass two main symptoms: delusional or Delusions and the Auditory hallucinations , Visual , Tactile or olfactory.
2. Negative symptoms
They are the other side of the symptom coin. They are characterized by being less noticeable than the positive symptoms but they affect more intensely and severely the wellness And the functionality of the subject.
Negative symptoms are formed by manifestations such as Affective flattening , the abulia , the apathy , Persevering thinking, language poverty or blockages.
3 - Disorganized symptoms
Disorganized symptoms refer to a series of directly visible manifestations in the patient's behavior. It is composed of signs such as disorganized language or behavior and inappropriate affectivity.
4 - Symptoms of excitation
In some cases, schizophrenia causes manifestations of excitation or brain stimulation that are diagnosed in a category other than positive symptoms.
5- Affective symptoms
Finally, schizophrenia can also lead to alterations in mood, causing Depressive symptoms Or decreased mood.
Diagnosis of schizophrenia
Schizophrenia is characterized by the presentation of the following diagnostic criteria:
1- Characteristic Symptoms: Two (or more) of the following, each present for a significant part of a period of 1 month (or less if successfully treated):
A) delusional ideas
B) hallucinations
C) disorganized language (eg, frequent derailment or incoherence)
D) catatonic or severely disorganized behavior
E) negative symptoms, for example, affective flattening, alogia or abulia.
2- Social / occupational dysfunction: For a significant part of the time since the beginning of the disturbance, one or more important areas of activity, such as work, interpersonal relationships or self care, are clearly below the previous level At the onset of the disorder
3- Duration: Continuous signs of alteration persist for at least 6 months. This 6-month period should include at least 1 month of symptoms that meet the
4- Exclusion of schizoaffective disorders and mood.
5- Exclusion of substance use and medical illness.
6- Relationship to generalized developmental disorder: If there is a history of autistic disorder or other generalized developmental disorder, the additional diagnosis of schizophrenia will only be made if delusional ideas or hallucinations are also maintained for at least 1 month
Diagnosis of undifferentiated schizophrenia
Undifferentiated schizophrenia is a subtype of the disease. Therefore, the diagnosis must meet the above criteria in a special way, so as to rule out the existence of another subtype of the disease.
The criteria to be used for the diagnosis of undifferentiated schizophrenia are:
1- Presence of a type of schizophrenia in which the symptoms of Criterion A are present, but does not meet the criteria for the paranoid, disorganized or catatonic type.
2- Codification of the undifferentiated disorder as a function of its course:
A) Episodic with residual interepisodic symptoms
B) Episodic with residual non-interepisodic symptoms
C) Continuous
D) Single episode in partial remission
E) Single episode in total remission
F) Other or unspecified pattern
G) Less than 1 year from the beginning of the first active phase symptoms
References
- Barlow D. and Nathan, P. (2010) The Oxford Handbook of Clinical Psychology. Oxford University Press.
- Caballo, V. (2011) Manual of psychopathology and psychological disorders. Madrid: Ed. Piramide.
- DSM-IV-TR Diagnostic and Statistical Manual of Mental Disorders (2002). [Links]
- Obiols, J. (Ed.) (2008). Manual of General Psychopathology. Madrid: New Library.
- Sadock, B. (2010) Kaplan & Sadock handbook of clinical psychiatry. (5th Ed.) Barcelona: Wolters Kluwer.