Published online by Cambridge University Press: 05 March 2020
Patients with schizophrenia who meet criteria for admission to an inpatient unit are generally quite ill. The so-called positive symptoms of schizophrenia, which can result in threatening behavior and loss of control, are the usual triggers for admission. Some admitted patients will be experiencing a first episode of illness (“first break”), while others are hospitalized with an exacerbation of preexisting schizophrenia. The most obvious – and most disruptive – symptoms are generally related to psychosis, with the loss of reality testing and impaired mental functioning [1, 2]. Psychosis usually presents with hallucinations, delusions, disorganized thinking, and/or bizarre or disruptive behavior (Table 1.1). The onset of illness or worsening of psychotic symptoms may be noticed by a family member, friend, teacher, coworker, employer, or caregiver who sees the patient behaving bizarrely and deteriorating in their ability to function. A patient may be so disruptive in the community that he or she is brought to the emergency department by the police.
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