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Schizophrenia. Diagnostic tests. 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.
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Schizophrenia Diagnostic tests
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
Diagnostic Tests Sensorium and cognition
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.”