Diagnosis
Every diagnosis made in this country must be “encrypted”, if one wants to do it professionally and not simply from the gut. This means that there are systems in which all diseases known to medicine are more or less well recorded. So a doctor cannot simply go and distribute diagnoses until certain criteria are met that the encryption system requires.
According to the Diagnostic Criteria of Schizophrenia according to ICD – 10 – Criteria, the following applies: schizophrenic disorders are generally characterized by fundamental and characteristic disorders of thinking and perception as well as inadequate or flattened affects. The clarity of consciousness and intellectual abilities are usually not impaired, although certain cognitive deficits may develop over time. he most important disease-specific phenomena are thought lingering, thought inspiration or withdrawal, thought propagation, delusional perception, control delusion, delusions of influence or the feeling of being made, voices commenting on or talking about the patient in the third person, thought disorders and negative symptoms.
The course of schizophrenic disorders can be either continuous, episodic with increasing or stable deficits, or one or more episodes with complete or incomplete remission. The diagnosis of schizophrenia should not be made in the case of pronounced depressive or manic symptoms, unless schizophrenic symptoms would have preceded the affective disorder. Neither should schizophrenia be diagnosed in cases of clear brain disease, during intoxication or during withdrawal syndrome.
Special forms of schizophrenia
Paranoid hallucinatory schizophrenia (ICD-10 F20. 0) Paranoid schizophrenia is characterized by persistent, often paranoid delusions, usually accompanied by auditory hallucinations and perceptual disorders. Disorders of mood, drive and speech, catatonic symptoms are either absent or not very noticeable.
Hebephrenic schizophrenia (ICD-10 F20. 1) A form of schizophrenia in which the affective changes are in the foreground, delusions and hallucinations are fleeting and fragmentary, behavior is irresponsible and unpredictable, and mannerisms are common. The mood is flat and inappropriate.
Thinking is disorganized, language is disorganized. The sick person tends to isolate himself socially. Because of the rapid development of negative symptoms, especially flattening of the emotions and loss of drive, the prognosis is usually poor.
As a rule, hebephrenia should only be diagnosed in adolescents or young adults. Catatonic schizophrenia (ICD-10 F20. 2) Catatonic schizophrenia is characterized by the predominant psychomotor disorders, which can alternate between extremes such as arousal and stupor as well as command automatism and negativism.
Forced postures and positions can be maintained for long periods of time. Episodic severe states of arousal can be a characteristic of this clinical picture. The catatonic phenomena can be associated with a dream-like (oneiroid) state with vivid scenic hallucinations.Schizophrenic Residuum (ICD-10 F20.
5) A chronic stage in the development of schizophrenic disease in which there is a clear deterioration from an early to a later stage and which is characterized by persistent but not necessarily irreversible “negative” symptoms. These include psychomotor retardation, reduced activity, flattening of affect, passivity and lack of initiative, qualitative and quantitative speech deprivation, low non-verbal communication through facial expression, eye contact, modulation of voice and posture, neglect of personal hygiene and declining social performance.
