My first Grand rounds presentation: Schizophrenia
I know I am always talking about how I am always learning something new every day...well today isn't any different. I was asked to do a presentation on a case for what we call grand rounds.
(This isn't me...duh. No one took a picture of me)
First of all...I was freaking out because it was my first presentation in grand rounds. This is when all the chiefs and attending physicians come and an intern (that's me) discuses a case in front of all of them.
I picked a very interesting case of a young guy with schizophrenia...but not the every day, "let's google it" kind of schizophrenia. This guy was not doing so well. I thought...well this is a cool case to present and learn something. I totally did. Here it goes...
Things I learned about schizophrenia:
1. Schizophrenia affects more than 21 million people worldwide
2. More than half (>50%) of all male schizophrenia patients, but only one-third (1/3)of all female schizophrenia patients, are first admitted to a psychiatric hospital before age 25 years.
Approximately 3-10% of women with schizophrenia present with disease onset after age 40 years
3. The classic course is based on exacerbations and remissions - After the first psychotic episode, a patient gradually recovers and may then function relatively normally for a long time. Patients usually relapse, however, and the pattern of illness during the first 5 years after the diagnosis generally indicates the patient's course. Further deterioration in the patient's baseline functioning follows each relapse of the psychosis.
4. 50% have poor prognosis leading to negative outcomes, like suicide, which is the leading cause of premature death in schizophrenic patients.
5. If it starts at a young age like early teens, can be very deteriorating.
CREDIT: Photo created by an artist with schizophrenia
6. When it begins in adolescence you can see a quiet, passive, and introverted person that as child had had few friends.
7. "Preschizophrenic adolescents" may have no close friends, not go on dates and may avoid team sports (kinda sounds like me in middle school...so don't get this confused). They may enjoy watching movies and television, listening to music, or playing computer games to the exclusion of social activities. Some adolescent patients may show a sudden onset of obsessive-compulsive behavior as part of the prodromal picture.
8. Withdrawn people or with autistic behavior – if you notice someone to be a little more withdrawn and to themselves not wanting to share or open up with you, possibly with poor eye contact
9. Family history of schizophrenia is a big one...as it tends to run in families
10. If someone has poor support systems around them can lead to worsening of the disease.