Symptoms of Acute Polymorphic Psychotic Disorder with Symptoms of Schizophrenia
This diagnosis is considered not only as the first with a schizophrenic manifest, but also in cases of a favorable course of the disease, for example, with prolonged remissions and spontaneous exits from psychosis, it is advisable to attribute each subsequent psychosis to this group, and not to schizophrenia or schizoaffective disorder. In the clinic of acute psychosis of this group, there are productive symptoms of the first rank characteristic of schizophrenia, but there are no negative emotional-volitional disorders. The affect of anxiety, expansion, confusion. Motor activity is increased up to excitement.
Diagnosis of Acute Polymorphic Psychotic Disorder with Symptoms of Schizophrenia
- Rapid changes in the symptoms of delirium, including delirium exposure, delusional interpretation and delusional perception characteristic of schizophrenia.
- Hallucinations, including auditory commentators, contradictory and mutually exclusive, imperative truths and pseudo-hallucinations, somatic hallucinations and a symptom of open thoughts, sounding of one’s own thoughts related to symptoms of the first rank in schizophrenia.
- Symptoms of emotional disorders: fear, anxiety, irritability, confusion.
- Motor excitement.
- The above productive symptoms of schizophrenia are noted for no more than a month.
Differential diagnosis
It should be differentiated from schizoaffective disorder, psychotic schizophrenia-like disorders in dependence on psychoactive substances. This psychosis differs from the clinic of schizoaffective disorder in that the period of affective disorders is shorter than the productive one, and productive symptoms of the first rank characteristic of schizophrenia are noted. Schizophrenia-like psychoses in addiction diseases and organic schizophrenia-like psychoses can be delimited using additional research methods (laboratory, somatic, neurological, neurophysiological) and on the basis of anamnesis.
Treatment of Acute Polymorphic Psychotic Disorder with Symptoms of Schizophrenia
In the treatment it is necessary to use detoxification therapy, antipsychotics in medium and sometimes in maximum doses. You should always prescribe supportive treatment with prolongations or conduct episodic short-term courses of therapy due to the risk of developing schizophrenia, and also insist on outpatient monitoring of the patient for at least one year. Pay attention to periods of sleep disturbances, emotional disturbances (episodes of anxiety), suspiciousness. It is these symptoms that can precede exacerbations, and therefore they are a signal for preventive therapy.