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Schizophrenia


Grossly disorganized or catatonic behavior (A4) is the last of the positive symptom category. Grossly disorganized behavior may manifest itself in a variety of ways, ranging from child like silliness to unpredicted agitation. Catatonic motor behaviors include a marked decrease in reactivity to the environment. .
             Negative symptoms (A5) account for a substantial degree of the morbidity associated with the disorder. Three negative symptoms are included in a definition of schizophrenia; affective flattening, alogia and avolition. Of the entire three negative symptoms, affective flattening is most common and it is characterized by the person's face appearing mobile and unresponsive with poor eye contact and reduced body language. Alogia is poverty of speech and it is manifested by brief, laconic, empty replies. The individual with alogia appears to have a diminution of thoughts that is reflected in decreased fluency and productivity of speech. Avolution is characterized by inability to initiate and persist in goal-directed activities; the person may sit for long periods of time and show little interest in participating at work or social activities. For one to be diagnosed with schizophrenia, the criterion A requires that least two of the five items be present concurrently for much of at least a month.
             The next criterion for diagnosing a patient with schizophrenia is social occupational dysfunction. Functioning is clearly below that which had been achieved before the onset of symptom; this could be at work, interpersonal relations or self-care. In case of children or adolescent, it could the failure to achieve expected level of interpersonal, academic or occupational achievement. Duration is another one of the diagnostic criteria for schizophrenia. Continuous signs of disturbance should persist for at least six months. The six month period must include at least one month of symptoms that meet criterion A and may include periods of prodomal or residual symptoms.


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