Schizophrenia à serious psychiatric disorder characterised by psychotic episodes
consisting of perceptual disturbances (hallucinations) , fixed false beliefs
(delusions) and disorganization in thinking, communication, and behaviour. It
typically runs a chronic course with global functional deterioration between
psychotic episodes. Affective blunting, attentional impairments, asocial behaviour,
and poor motivation.
Psychotic behaviour à severe psychological disorder category characterised by
hallucinations and departures from reality
Psychosis: Gross departure from reality, which may include:
® Hallucinations: Sensory experiences in the absence of sensory input (e.g.
hearing voices)
® Delusions: Strong, inaccurate beliefs that persist in the face of evidence to the
contrary
Nature of Schizophrenia and Psychosis
Emil Kraepelin – “dementia praecox”
Eugen Bleuler – “schizophrenia” & “associative splitting”
Early subtypes of schizophrenia:
1. Catatonia à disorder of movement involving immobility or excited agitation,
sometimes accompanies psychotic disorder or mood disorders as well as
neurological conditions
2. Hebephrenia à silly and immature emotionality, a characteristic of some
types of schizophrenia
3. Paranoia à irrational beliefs that overwise neutral events have bearing one or
bear reference to the sufferer
Diagnosis & Symptoms of Schizophrenia
• A Diagnoses of schizophrenia – two or more, positive, negative, or
disorganised symptoms (present for at least a month)
Overt productive symptoms such as delusions and
hallucinations
Positive Delusions à disturbed thought content conceptualized
as a fixed false belief
Symptoms
• Most common delusions: grandeur & persecution
Hallucinations à perceptual disturbance in which
things are seen, heard, or sensed without environmental
input
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• Most common: auditory hallucinations (abnormal
auditory perceptions in the absence of external
stimulation of the auditory system) – linked to
Broca’s area
• Formed hallucinations (actual voices) Vs
Unformed hallucinations (poorly formed,
indistinct sounds)
Deficit symptoms (affective blunting, attentional,
motivational, and social impairment)
• Absence of normal behaviour
Negative
Symptoms Avolition (or apathy) à lack of initiation and
persistence in important activities
Alogia à deficiency in the amount or content of speech
Anhedonia à lack of pleasure or indifference
Affective flattening à emotionless demeanor
Asociality à inclination to social isolation and lack of
engagement
Abnormal speech, behaviour, and emotion
Disorganised speech:
• Cognitive slippage à illogical and incoherent
speech
• Tangentiality à “going off on a tangent”
Disorganised
• Loose associations à conversation in unrelated
Symptoms directions
• Derailment à changing the conversations in the
complete opposite direction
Disorganised affect à inappropriate emotional behaviour
Disorganised behaviour à variety of unusual behaviours
(catatonia)
In the past Schizophrenia was previously divided into subtypes: paranoid, catatonic,
residual, disorganised and undifferentiated
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