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Schizophrenia, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • A chronic psychotic disorder characterized by delusions, hallucinations, disorganization, negative symptoms, and cognitive deficits:

    • Premorbid phase:

      • Development of negative symptoms w...

Diagnosis

Signs and Symptoms

Criteria of the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) require the presence of at least 2 of the following symptoms for more than 6 mo: 
  • Delusions...

Treatment

Pre-Hospital

  • Patients can display unpredictable and violent behavior toward themselves and others

  • Patients may require police presence and/or restraints to maintain safety

  • Local laws vary as th...

Follow-Up

Disposition

Admission Criteria

  • Admit to inpatient psychiatric hospital, if patient is medically stable and:

    • Is a danger to self or others

    • Is gravely disabled and unable to care for himself due t...

Pearls and Pitfalls

  • Visual, olfactory, gustatory, or tactile hallucinations should prompt medical workup for secondary causes of psychosis, as should atypical age of onset (>30 yr old)

  • Early treatme...

Additional Reading

  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Text Revision (DMS-IV-TR), American Psychiatric Association, Washington, DC; 2000.

  • ...

Codes

ICD9

  • 295.10 Disorganized type schizophrenia, unspecified

  • 295.20 Catatonic type schizophrenia, unspecified state

  • 295.90 Unspecified schizophrenia, unspecified state

  • 295.30 Paranoid type schizophrenia...

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