Undifferentiated schizophrenia: symptoms, causes, and treatment.

This type of schizophrenia appears in ICD-10 and earlier versions of the DSM.

Schizophrenia is the psychotic disorder par excellence, although we can really speak of a group of disorders. This psychiatric disorder can become truly disabling, and affects all areas of a person's life.

Here we will get to know a "subtype" of schizophrenia, which appeared in the DSM-IV-TR: undifferentiated schizophrenia.A category in which to classify those cases that do not fit the diagnostic criteria of the other specific types of schizophrenia.

Undifferentiated schizophrenia: inclusion in the manuals.

The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) was the last edition to include undifferentiated schizophrenia, with the name "undifferentiated type of schizophrenia".

This is because in the DSM-5 the schizophrenia subtypes of the DSM-IV-TR were eliminated.. The reason was their poor diagnostic stability, low reliability, poor validity and low clinical utility. In addition, with the exception of the paranoid and undifferentiated subtypes, the other subtypes were rarely used in most parts of the world. However, their removal from the DSM-5 was not accepted by all mental health professionals.

On the other hand, undifferentiated schizophrenia also appears in the ICD-10 (International Classification of Diseases), as we will see below.

General characteristics

According to the DSM-IV-TR, undifferentiated schizophrenia is a type of schizophrenia in which the symptoms of Criterion A schizophrenia are present but which does not meet the criteria for paranoid, disorganized or catatonic schizophrenia..

ICD-10, on the other hand, states that it is a set of disorders that meet the general guidelines for the diagnosis of schizophrenia but do not fit into any of the existing types of schizophrenia, or have features of more than one of them, with no clear predominance of one in particular.

Following ICD-10, this category should be used only for psychotic conditions, excluding residual schizophrenia and post-schizophrenic depression, and only after an attempt has been made to classify the disorder as schizophrenia, and only after an attempt has been made to classify it as schizophrenia.and only after having tried to classify the clinical picture in one of the other categories or subtypes. In addition, the diagnosis is compatible with atypical schizophrenia.

Symptoms

The symptoms of undifferentiated schizophrenia are as follows.

1. Criteria for schizophrenia

The guidelines for the diagnosis of schizophrenia must be met. This involves criterion A (two or more, for one month or less if successfully treated):

• Delusional ideas.
• Hallucinations.
• Disorganized language.
• Catatonic or disorganized behavior.
• Negative symptoms (e.g. Abulia or affective flattening).

2. Does not correspond to another subtype

It is not any other subtype of schizophrenia (catatonic, hebephrenic or paranoid), and therefore its diagnostic guidelines are not met.

3. It is not residual schizophrenia or post-schizophrenic depression.

It does not meet the guidelines for residual schizophrenia or post-schizophrenic depression, although it may have features of either.

Causes

Research suggests a variety of explanatory theories regarding the etiology or origin of schizophrenia itself, broadly extensible to undifferentiated schizophrenia. Some of the models or hypotheses implicated in the emergence of schizophrenia are:

1. stress-diathesis model.

This model proposes that there are people with a previous vulnerability (diathesis) (diathesis) who end up developing schizophrenic symptomatology as a result of stressors (biological or environmental).

Biological models

Much research, especially in recent years, suggests the presence of some dysfunctions in specific areas of the some dysfunctions in specific areas of the brain (limbic system (limbic system, frontal cortex and basal ganglia) as the cause of the pathological process.

Genetic models

They propose a heritability component, as a result of research with adopted monozygotic twins, indicating similar morbidity proportions regardless of the rearing environment..

4. Psychosocial models

They posit psychosocial factors at the basis of the development of schizophrenia, such as certain stressors, stressful life events, dysfunctional family dynamics, and dysfunctional family dynamics. stressors, stressful life events, dysfunctional family dynamics, etc., etc.etc.

Treatment

As always, treatment should be adapted to the needs and particularities of the patient, especially taking into account that this is not a "classic" or common schizophrenia, but a type of schizophrenia that does not meet the criteria for classification in any particular subtype. Therefore, the characteristics or symptoms will depend more than ever on the patient himself..

An integrative treatment will be the best therapeutic option, combining pharmacological treatment (neuroleptics, antidepressants,...) with psychological treatment.

The psychological intervention may be cognitive-behavioral, systemic or other approaches; The priority will be to treat the patient, always considering his or her environment and the dynamics that occur in their family environment, which are usually dysfunctional.

On the other hand, a psychosocial approach that includes psychoeducational guidelines, work rehabilitation and activation of family and social support networks, among others, will be essential.

Bibliographic references:

• WHO: ICD-10. (1992). Mental and Behavioral Disorders. Tenth Revision of the International Classification of Diseases. Clinical descriptions and guidelines for diagnosis. World Health Organization, Geneva.
• American Psychiatric Association (2000). DSM-IV-TR. Diagnostic and statistical manual of mental disorders (4thEdition Reviewed). Washington, DC: Author.
• Kaplan, Sadock B.J., Sadock V.A. (2003). Clinical psychiatry. Pocket manual. Editorial Waverly Hispánica, Madrid