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In the period leading up to the first episode of schizophrenia, uncharacteristic basic symptoms first appear and are followed by the onset of more characteristic basic symptoms and, finally, psychosis. [9] Basic symptoms often appear several years before the onset of psychosis, but are often preceded by the onset of self-disorders. [10]
Positive symptoms are those symptoms that are not normally experienced, but are present in people during a psychotic episode in schizophrenia, including delusions, hallucinations, and disorganized thoughts, speech and behavior or inappropriate affect, typically regarded as manifestations of psychosis. [36]
Because psychosis may be precipitated or exacerbated by common classes of medications, medication-induced psychosis should be ruled out, particularly for first-episode psychosis. Both substance- and medication-induced psychosis can be excluded to a high level of certainty, using toxicology screening.
In McGorry’s conception, schizophrenia goes through a “prodrome” stage when symptoms gradually emerge, a “first episode” phase that covers, on average, the two years before the first break and finally a “chronic” phase when the disease causes a steady deterioration in many patients that can be difficult if not impossible to reverse.
Schizophreniform disorder is a type of mental illness that is characterized by psychosis and closely related to schizophrenia.Both schizophrenia and schizophreniform disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), have the same symptoms and essential features except for two differences: the level of functional impairment and the duration of symptoms.
After the end of the psychosis, patient can describe some fragments of their psychopathological experiences, but this story is usually inconsistent. [4] An oneiroid-schizophrenic state also can be induced by the Kandinsky-Clérambault syndrome. [5] This is typical for people with paranoid schizophrenia who also suffer from the oneiroid syndrome.
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