Last reviewed: November 2018
Last updated: June  2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • auditory hallucinations
  • delusions
  • avolition
  • anhedonia
  • asocial behaviour
  • affective blunting
  • alogia
  • cognitive deficits
  • somatisation

Other diagnostic factors

  • bizarre or disorganised/catatonic behaviour
  • tangentiality and looseness of association (derailment)
  • circumstantiality
  • pressured speech
  • distractible speech
  • depression
  • suicidality
  • anxiety
  • elation
  • incongruent affect
  • verbigeration
  • perseveration
  • word salad
  • derealisation
  • non-auditory hallucinations
  • déjà-vu
  • stilted goal-directed behaviours
  • catatonic symptoms
  • 'soft' neurological deficits

Risk factors

  • family history of schizophrenia
  • increasing paternal age
  • obstetric complications
  • cannabis use
  • low IQ
  • motor dysfunction
  • psychological stress
  • childhood abuse
  • birth in late winter/early spring season
  • cooler climate
  • migrant status

Diagnostic investigations

Investigations to consider

  • CT/MRI head
  • serum HIV enzyme-linked immunosorbent assay
  • serum rapid plasma reagin test
  • FBC
  • urine drug screen
  • plasma drug level monitoring
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Adrian Preda

Professor of Clinical Psychiatry

Department of Psychiatry and Human Behavior

University of California, Irvine School of Medicine

Irvine

CA

Disclosures

AP received a fee for consulting from Boehringer Ingelheim and a fee for speaking from Dainippon Sumitomo Pharma America, the manufacturer of lurasidone/Latuda.

Robert G. Bota

Associate Clinical Professor of Psychiatry

University of California

Irvine

CA

Disclosures

RGB declares that he has no competing interests.

Dr Adrian Preda and Dr Robert G. Bota would like to gratefully acknowledge Dr Manish Kumar, who assisted with research for this topic. MK declares that he has no competing interests.

Peer reviewers VIEW ALL

Chief Pharmacist

South London and Maudsley NHS Foundation Trust

London

UK

Disclosures

DT declares that he has no competing interests.

Professor

Department of Psychiatry

University of New Mexico School of Medicine

Albuquerque

NM

Disclosures

JY declares that he has no competing interests.

Professor of Psychiatry

University of Missouri Kansas City

Kansas City

MO

Disclosures

KS declares that he has no competing interests.

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