User:D23sunn/Project Proposal

Pseudoneurotic Schizophrenia

Pseudoneurotic schizophrenia is defined by Stedman's Medical Dictionary as "schizophrenia in which the underlying psychotic process is masked by complaints ordinarily regarded as neurotic." A person is diagnosed with borderline schizophrenia when they exhibit one or another of non-psychotic symptoms such as anxiety, hysteria, phobic or obsessive-compulsive neuroses. A patient is designated with pseudoneurotic schizophrenia if they display a combination of two or more neurotic symptoms, and/or psychosomatic and psychopathic symptoms.

History
Pseudoneurotic schizophrenia is a term first coined by Paul Hoch and Philip Polatin in the late 1940s and is used to describe patients who exhibit anxiety symptoms that hide a psychotic disorder discovered later. The term has fallen out of favor recently and is not used in current classification systems. One of the primary reasons for this is the development of the term “borderline personality disorder” which was brought about and introduced into the DSM-III in 1980. The diagnosis of borderline personality disorder is based primarily on the mood and behavior of the patient. As a result, many of the patients once considered to have pseudoneurotic schizophrenia have been re-diagnosed with borderline personality disorder. In 1962 a ten year follow up was performed on patients previously diagnosed with pseudoneurotic schizophrenia, with twenty percent found to have transitioned to conventional schizophrenia.

Diagnosis
Currently the term Pseudoneurotic Schizophrenia has fallen out of use and is not part of any current classification systems.

Causes
Pseudoneurotic Schizophrenia is defined as a form a schizophrenia marked by neurotic symptoms that cover up the psychotic elements traditionally observed with the disease. When the term was still in popular use, patients diagnosed with Pseudoneurotic Schizophrenia were thought to have neurotic symptoms caused by a psychotic disorder. Today, it is believed that personality disorders which cause neurotic symptoms are caused by non-schizophrenic diseases such as Borderline Personality Disorder (BPD) are not necessarily connected to psychosis. This is supported by studies that show neither family history nor biological markers supporting a link between BPD and schizophrenia.

Symptoms
The symptoms of pseudoneurotic schizophrenia are on the borderline between psychosis and neurosis. This is primarily what leads to the masking of schizophrenia with the more common symptoms of anxiety. There are three primary major symptom categories. The first is having a thought disorder of some kind. The second is having a low mood. The final symptom category includes altered temperature perception and generalized weakness with prominent secondary symptoms. These secondary symptoms can include panic attacks, generalized anxiety, and finally specific health anxieties.

Treatments
There are records of some patients with depressive features that had received electroconvulsive therapy, but had only experienced temporary relief. Another form of treatment is psychosurgery which include but are not limited to precoronal lobotomy, medial lobotomy, and topectomy operations.

As diagnosis of Pseudoneurotic Schizophrenia has been mostly supplanted by BPD, treatment has been mostly adjusted to account for this fact.