2 Electro-convusive therapy (ECT) - About 6 to10 convulsions spread out over a period of 2 to 4 weeks Indcations

Good Risperidone 4-8 mg od or bd orally Doses less than mg/day are less likely to cause extrapyramidal symptoms 2 Electro-convusive therapy (ECT) - About 6 to10 convulsions spread out over a period of 2 to 4 weeks Indcations (a) Caiaconic and paranoid schizophrenia (b) Stupor. excitement or violent behaviour of the patient (c) Associated syrnptoms of depression or mania (d) Suicidal and homicidal tendencies (e) Patients not responding to the other treatments 3 Psychothgrapy and Case work - Supportive paychontharapy indicated(a) early schizophrenics, (b) rnaintenance and rehabilitation of recovered patients Anatytical or deep psychotherapy usually avoided In schizophrenic patients Case work by psyatric social worker is quite useful in (i) modyfing the environment (physical as well as psychological) so as to make it less stressful for The palisnl. (ii) eslablshing harmonioua relationship with people around, i e. family, friends relatives, people at work, etc . (iii) rahabilltating the recovered pattern in Schlzoprirenirormpeychosis - This resembles schizophrenia in its clinical manifesiations The difference is in the duration of illness Whille schizophrenic syrnptoms have to be of at least 6 months' duration, symptoms of schizophreniforn psychosis should be present for more than 2 weeks bul less than 6months Treatment -Same as schizophrenia lll. Brief reactve psychpsis - As. the nama suggests, the symptoms of.this disorder appear in reaction to recognisable psychosocial stresses Clinical picture is characterised by preserves of emorional turmoil and florid psychotic symptoms such as delirium hallucinations, incoherence and grossly ofeorganfsed behaviour These syrnptoms should be prsseni for less than 2 weeks Treatment - Antipsycholic drugs as in schizophrenia, although some cases are known to remit spontaneously. IV Schizo-affective disorder - Characterised by the simultaneous occurrence of schizophrenic symptom and symptoms of an affective or mood disorder, after depression or elation This diagnosis carries a better prognosis than schizophrenia. Treatment - Antipsychotic: drug, as in schizophrenia or In combination with antidepressants (in presence of depressive symptoms) Antipsychotic drugs are also efficacious when administered in combination with following mood stabilizers. (a) Lithium carbonate 600-1500 mg/day orally so as to achieve serum lithium levels ranging from 0.6-1.0 Eq /L. (b) Sodium evaporated 600-1500 mg/day orally (c) Divalproex (d) Carbamazepine 600-1200 mg/day orally Drug treatment can be given co currently with ECT and supportive psychotherapy. V. Delusional disorders -Characterized by occurrence of non-bizarre, persistent, well-systematized delusions of persecution of Jealousy In contrast to the bizarre delusions seen in schizophrenia Unlike schizophrenia hallucinations, are absent in delusional disorders. The non-bizarre delusions usually involve situations that could occur In reality. such as being followed, poisoned or deceived by spouse or lover. These delusions should be present or at least one month. The behaviors and emotions are appropriate to the content of the delusional system Apart from the impact of delusions, daily functioning is not markedly Impaired. A related condition is shared Delusional Disorder In which a delusional system develops in a person as a result of his close friendship with another person who has a delusional disorder. 2. MOOD DISORDERS Definition. The mood disorders are so called because their main feature is an abnormality of affect or mood This