It is a group of mental illness with unknown causes, which mostly starts in young adults and often causes many obstacles in perception, thinking, emotion, behavior and so on, as well as incoordination of mental activities. Generally, there is unconsciousness and mental retardation, and the course of the disease is often protracted.

1. Heredity 2. Neurodevelopmental abnormalities 3. Neurobiochemical research: dopamine hypothesis, 5-hydroxytryptamine hypothesis, glutamate hypothesis, r-an'ji'ding aminobutyric acid hypothesis

prodromal symptoms

Symptoms in the manifest stage

Classification: 1. Simple type: negative symptoms in adolescence 2. Adolescent type: positive symptoms in adolescence 3. Paranoid type: positive symptoms in adults (delusions) 4. Catatonic type: alternating catatonic excitement & stupor in adults 5. Undifferentiated type 6. Residual type: negative symptoms but no positive symptoms 7. Depression after separation: first separation---depression later

Diagnosis: 1. Appears continuously for a long time on the basis of clear consciousness: (1) Thought ringing, thought insertion or thought removal, and thought broadcasting (2) Clearly involving body or limb movements, or special thoughts, actions or feelings Delusions and delusional perceptions of being influenced, controlled or passive (3) Auditory hallucinations that follow the patient's behavior, or discuss the patient with each other, or other types of auditory hallucinations originating from certain parts of the body (4) Other types of persistent delusions that are culturally incompatible and impossible 2. Characteristics of the course of the disease: (1) Persistence (2) The first episode requires the presence of at least one of symptom items 1-4 most of the time for 1 month or more

Differential diagnosis: 1. Secondary psychotic disorders: (1) Physical/brain organic diseases: hallucinations are predominant, lighter during the day and heavier at night, with few characteristic symptoms of schizophrenia (2) Certain psychoactive substances & Caused by therapeutic drugs: ①Schizoid disorder: duration of disease <1 month [disease does not resolve for more than 1 month] ②Acute transient mental disorder: onset suddenly without prodromal symptoms, peaking within 2 weeks, Changes occur every day, and are completely relieved within a few days. ③ Schizoaffective disorder: The duration of the disease is <1 month. During a disease episode, both psychotic symptoms and affective disorders (mania or depression) are obvious and appear or subside at about the same time. ④ Delusional disorder: The delusion has a strict structure and a certain factual basis, the thinking is organized and logical, the behavioral and emotional reactions are consistent with the content of the delusion, there is no intelligence and personality decline, and no hallucinations 2. Other psychotic disorders 3. Mood disorders: ( 1) Depression: Apathy, emotional communication, low muscle tone (2) Catatonic stupor: Apathy, disobedience, catatonic excitement, high muscle tone 4. Anxiety & obsessive-compulsive disorder 5. Personality disorder

Course of the disease: 1. Onset in adolescence 2. Alternate deterioration and remission 3. Disease characteristics in the first five years can predict the later course of the disease 4. Worsening after each attack 5. After an attack, some patients will have depressive episodes 6. Positive symptoms become less severe and negative or defective symptoms become more severe

Drug treatment: 1. Principle: early, individualized, sufficient dose (start with a small dose and slowly reach the best personal dose), single medication 2. Mechanism: acts on the midbrain-limbic system 3. Time: (1) Acute phase: 4 -6w (2) Consolidation period: at least 6 months (3) Maintenance period: at least 5 years 4. Drug selection:

Adverse drug reactions: 1. Drug-induced Parkinson’s disease: resting tremor – discontinue medication and observe 2. Malignant tumors: chills, high fever, dystonia after taking antipsychotics – discontinue medication immediately 3. Risperidone, etc. Acts on the nodule-infundibulum pathway---reduced prolactin inhibitory factor---increased prolactin---amenorrhea and lactation---immediate discontinuation of the drug 4. Clozapine---granulocytopenia [another one can cause granulocytes Reduced drugs---anti-hyperthyroidism drugs: propylthiouracil]