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Summary Introduction and Biological Approaches to Schizophrenia
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Detailed coverage of an introduction to schizophrenia as well as the biological approach to schizophrenia.
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Section 2-SchizophreniaSchizophrenia
Key Terms:
Key Term Definition
Schizophrenia A severe mental illness where contact with reality and
insight are impaired, an example of psychosis.
Classification of mental disorder The process of organising symptoms into categories
based on which symptoms cluster together in sufferers
Positive symptoms of schizophrenia Atypical symptoms experienced in addition to normal
experiences. They include hallucinations and delusions.
Hallucinations A positive symptom of schizophrenia. They are sensory
experiences of stimuli that have either no basis in
reality or are distorted perceptions of things that are
there.
Delusions A positive symptom of schizophrenia. They involve
beliefs that have no basis in reality, for example, that
the sufferer is someone else or that they are the victim
of a conspiracy.
Negative symptoms of schizophrenia Atypical experiences that represent the loss of a usual
experience such as clear thinking ‘normal’ levels of
motivation.
Speech poverty A negative symptom of schizophrenia. It involves
reduced frequency and quality of speech.
Avolition A negative symptom of schizophrenia. It involves the
loss of motivation to carry out tasks and results in
lowered activity levels.
Co-morbidity The occurrence of two illnesses or conditions together,
for example a person has both schizophrenia and a
personality disorder. Where two conditions are
frequently diagnosed together it calls into question the
validity of classifying the two disorders separately.
Symptom overlap Occurs when two or more conditions share symptoms.
Where conditions share many symptoms this calls into
question the validity of classifying the two disorders
separately.
Diagnosis and classification of schizophrenia
Schizophrenia is a mental disorder suffered by about 1% of the world population. It is more commonly diagnosed in
men than women, more commonly diagnosed in cities than the countryside and in working-class rather than middle-
class people. The symptoms of schizophrenia can interfere severely with everyday tasks, so that many sufferers end
up homeless or hospitalised.
Classification of schizophrenia
Schizophrenia does not have a single defining characteristic. It is a cluster of symptoms some of which appear to be
unrelated. The two major systems for the classification of mental disorder, are the World Health Organisation’s
International Classification of Disease edition 10 (ICD-10) and the American Psychiatric Association’s Diagnostic
and Statistical Manual edition 5 (DSM-5, sometimes written as DSM-V). These differ slightly in their classification of
schizophrenia. For example, in the DSM-5 system one of the so-called positive symptoms-delusions, hallucinations
or speech disorganisation-must be present for diagnosis whereas two or more negative symptoms are sufficient
under ICD-10.
, ICD-10 recognises a range of subtypes of schizophrenia. Paranoid schizophrenia is characterised by powerful
delusions and hallucinations but relatively few other symptoms. Hebephrenic schizophrenia, on the other hand,
involves primarily negative symptoms. The defining characteristic of catatonic schizophrenia is disturbance to the
movement, leaving the sufferer immobile or alternatively overreactive. Previous editions of the DSM system also
recognised the subtypes of schizophrenia but this has been dropped in the DSM-5.
Positive symptoms
Positive symptoms of schizophrenia are additional experiences beyond those of ordinary existence. They include
hallucinations and delusions.
Hallucinations These are unusual sensory experiences. Some hallucinations are related to events in the environment
whereas others bare no relationship to what the senses are picking up from the environment, for example, voices
heard either talking to or commenting on the sufferer, often criticising them. Hallucinations can be experienced in
relation to any sense. The sufferer may, for example, see distorted facial expressions or occasionally people or
animals that are not there.
Delusions Also known as paranoia, delusions are irrational beliefs. These can take range of forms. Common
delusions involve being an important historical, political or religious figure, such as Jesus or Napoleon. Delusions also
commonly involve being persecuted, perhaps by government or aliens or of having superpowers. Another class of
delusions concern the body. Sufferers may believe they or a part of them is under external control. Delusions can
make a sufferer of schizophrenia behave in ways that make sense to them but seem bizarre to others. Although the
vast majority of sufferers are not aggressive and are, in fact, mote likely to be victims than perpetrators of violence,
some delusions can lead to aggression.
Negative symptoms
Negative symptoms of schizophrenia involve the loss of usual abilities and experiences. Examples include avolition
and speech poverty.
Avolition Sometimes called ‘apathy’, can be described as finding it difficult to begin or keep up with goal-directed
activity, I.e. actions performed in order to achieve a result. Sufferers of schizophrenia often have sharply reduced
motivation to carry out a range of activities. Anderson (1982) identified three signs of avolition; poor hygiene and
grooming; lack of persistence in work or education and lack of energy.
Speech poverty Schizophrenia is characterised by changes in patterns of speech. The ICD-10 recognises speech
poverty as a negative symptom. This is because of emphasis is on reduction in the amount and quality of speech in
schizophrenia. This is sometimes accompanied by a delay in the sufferer’s verbal responses during conversation.
Nowadays, however, the DSM system places its emphasis on speech disorganisation in which speech becomes
incoherent or the speaker changes topic mid-sentence. This is classified in DSM-5 as a positive symptom of
schizophrenia, whilst speech poverty remains as a negative symptom.
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