Undifferentiated Schizophrenia: Symptoms, Causes And Treatment
Schizophrenia is the psychotic disorder par excellence, although we can really talk about a group of disorders. This psychiatric disorder can be truly disabling, and affects all areas of the person’s life.
Here we will learn about a “subtype” of schizophrenia, which appeared in the DSM-IV-TR: undifferentiated schizophrenia a category to classify those cases that do not fit the diagnostic criteria of the other specific types of schizophrenia.
Undifferentiated schizophrenia: inclusion in manuals
The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) was the last edition where undifferentiated schizophrenia was included, with the name “undifferentiated type of schizophrenia.”
That is so because in the DSM-5 the subtypes of schizophrenia were removed from the DSM-IV-TR The reason was its poor diagnostic stability, low reliability, poor validity and poor clinical usefulness. Furthermore, except for the paranoid and undifferentiated subtypes, the other subtypes were rarely used in most of the world. However, its 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 later.
General characteristics
According to the DSM-IV-TR, undifferentiated schizophrenia is a type of schizophrenia in which the symptoms of Criterion A of schizophrenia are present, but does not meet the criteria for paranoid, disorganized, or catatonic type
The ICD-10, for its part, establishes that it is a set of disorders that satisfy the general guidelines for the diagnosis of schizophrenia but that do not fit any of the existing types of schizophrenia, or present features of more than one of them. them, without there being a clear predominance of one in particular.
Following the ICD-10, This category should be used only in psychotic conditions, excluding residual schizophrenia and post-schizophrenic depression, and only after having attempted to classify the clinical picture into one of the other categories or subtypes. Furthermore, the diagnosis is compatible with atypical Schizophrenia.
Symptoms
The symptoms of undifferentiated schizophrenia are as follows.
1. Criteria for schizophrenia
Guidelines for the diagnosis of schizophrenia must be met. This implies criterion A (two or more, for one month or less if successfully treated):
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.
The guidelines for residual schizophrenia or post-schizophrenic depression are not met, although it may present features of one of them.
Causes
Research suggests a variety of explanatory theories in relation to the etiology or origin of schizophrenia itself, broadly applicable to undifferentiated schizophrenia. Some of the models or hypotheses involved in the appearance of schizophrenia are:
1. Stress-diathesis model
This model proposes that There are people with a prior vulnerability (diathesis) that end up developing schizophrenic symptoms due to stressors (biological or environmental).
Many investigations, especially in recent years, raise the presence of some dysfunctions in specific areas of the brain (limbic system, frontal cortex and basal ganglia) as causes of the pathological process.
3. Genetic models
They propose a heritability component, following research with adopted monozygotic twins, which indicate similar morbidity proportions regardless of the upbringing environment
4. Psychosocial models
They propose psychosocial factors at the base of the development of schizophrenia, such as certain stressors, stressful life events, dysfunctional family dynamics etc.
Treatment
The treatment must be adapted as always to the needs and particularities of the patient, and even more so taking into account that it is not a “classic” or common schizophrenia, but rather a type of schizophrenia that does not meet the criteria to classify it into any specific 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; It will be a priority to treat the patient always considering their 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.
