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DIAGNOSTIC TESTSSchizophrenia
Impulsiveness, Violence, Suicide and Homicide
• IMSULSIVENESS– Agitated, little impulse
control– Decreased social
sensitivity– Suicide and homicide
attempts in response to hallucinations
Impulsiveness, Violence, Suicide and Homicide
• VIOLENCE. – Excluding homicide – Risk factors:
• Delusions of persecutory behavior
• Previous episodes of violence
• Neurologic deficits
Impulsiveness, Violence, Suicide and Homicide
• SUICIDE– 50% of all schizophrenia patients attempt suicide
(10-15% die by suicide)– Precipitants of suicide:• Misdiagnosed depression• Feelings of absolute emptiness• Need to escape from mental torture• Auditory hallucinations
Impulsiveness, Violence, Suicide and Homicide
• SUICIDE– Risk factors:
• Awareness of the illness, • Male sex, • College education,• Young age• A change in the course of the disease• Improvement after a relapse• Dependence on the hospital• Overly high ambitions• Previous suicide attempts early in the course of the disease• Living alone
Impulsiveness, Violence, Suicide and Homicide
• HOMICIDE– Same incidence as in general population– Unpredictable or bizarre reasons based
on hallucinations or delusions– Possible predictors:
• History of previous violence• Dangerous behavior while hospitalized• Hallucinations or delusions involving such
violence
SENSORIUM AND COGNITIONDiagnostic Tests
Orientation
• Usually oriented to person, time, and place• Some may give incorrect or bizarre answers– “I am Christ; this is heaven; and it is AD 35.”