Paranoid Schizophrenia

In this type of schizophrenia mood and cognitive functions have been well preserved, but the hall marks of abnormality are delusions and auditory hallucinations.

The patients typically have grandiose( they are king of the world) or persecutory delusions (they think someone is going to get them).

There can be other themes such as semi-religious topics, jealousy or somatization. It may be difficult to separate the schizophrenic delusional semi-religious patient from the normal cult member. However, the other religious members will be able to point out who is "off the wall". Physicians can be haunted by patients with somatazation delusions who will not accept that they are healthy.

After seeing specialists of every kind who all have given them a clean bill of health with a series of entirely normal test results the patients with paranoid schizophrenia in their delusional belief are still convinced there is something seriously wrong (somatizational delusions). Often only extensive tests that all show no abnormality in combination with a referral to a psychiatrist will pinpoint the diagnosis to "paranoid type schizophrenia". This type of schizophrenia has a better than average outlook for long term independent functioning with regard to occupation and independent living.

Disorganized Schizophrenia

The three cardinal signs of this subtype of schizophrenia are: disorganized speech, disorganized behavior and flat, inappropriate affect(Ref.2).


There might be inappropriate laughter or silliness that is not really related to the content of speech. The inability to follow through on goal oriented behavior such as daily activities of getting dressed, preparing meals, taking a bath etc. can have consequences of having to be referred into a home with supervision. Apart from the flat affect there is also inappropriate grimacing and a peculiar sequence of mini behaviors called "mannerism" and other strange behaviors. This subtype of schizophrenia shows up with marked abnormalities on cognitive and neurophysiological tests. The long term prognosis, particularly when it starts early in life, is poor with a high percentage of patients ending up in hospitals or care homes.

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

  1. Dr. David Burns: "Feeling good --The new mood therapy", Avon    Books, New  York,1992.

  2. Diagnostic and Statistical Manual of Mental Disorders, Fourth    Edition, (DSM-IV),American Psychiatric Association,    Washington,DC,1994.

  3. Dr. Shaila Misri at the 46th St. Paul's Hosp. Cont. Educ. Conference,    November 2000, Vancouver/B.C./ Canada.

  4. JM Loftis et al. J Neurochem 2000 Nov 75(5): 2040-2050.

  5. B. Zilbergeld et al. "Hypnosis - Questions& Answers", W.W. Norton    & Co, New York,1986: 307-312.

  6. MH Erickson & EL Rossi:"Hypnotherapy, an exploratory casebook",     Irvington Publishers Inc., New York, 1979: chapter 8, 314-363.

  7. G Steketee et al. Compr Psychiatry 2001 Jan 42(1): 76-86.

  8. DS Mennin et al. J Anxiety Disord 2000 July-Aug 14(4): 325- 343.

  9. J Hartland: "Medical &Dental Hypnosis and its Clinical Applications",     2nd edition, Bailliere Tindall,London,1982, page: 326-336.

Last Modified: June 21, 2012