Schizophrenia Flashcards
(38 cards)
Schizophrenia
Schizophrenia is a severe mental disorder characterised by a profound disconnection from reality, involving a disruption of cognition and emotion.
What aspects of functioning are affected by schizophrenia? (x4)
- Language
- Thought
- Perception
- Sense of self
At what age is schizophrenia typically diagnosed?
Between 15 and 35.
Who is more commonly affected by schizophrenia?
It is more commonly diagnosed in men, in cities, and in the working-class population.
How prevalent is schizophrenia?
Schizophrenia ranks among the top 10 causes of disability worldwide, and affects about 1% of the population at some point in their lives (Mathers et al, 1996).
What are positive symptoms?
Atypical symptoms experienced in addition to normal experiences.
What are negative symptoms?
Atypical symptoms that represent a loss to normal experiences.
What are the positive symptoms of schizophrenia? (x2)
- Hallucinations
- Delusions
What are the negative symptoms of schizophrenia? (x2)
- Avolition
- Speech poverty
What are hallucinations?
- Unusual sensory perceptual experiences.
- May or may not be related to events in the environment.
- Voices heard either talking to or commenting on the sufferer, often criticising them.
- Hallucinations can be experienced in relation to any sense (hearing, seeing, feeling, taste or touch).
What are delusions?
Irrational, bizarre beliefs that seem real to the person with schizophrenia.
What are the different forms of delusions? (x3)
- Delusions of grandeur (e.g involve being an important historical, political or religious figure, such as Jesus or Napoleon).
- Paranoid / persecutory delusions (being persecuted, perhaps by government or aliens or of having superpowers).
- Delusions of reference (may believe they are under external control, or that the events in the environment are directly related to them, e.g personal messages through the TV).
What are the negative symptoms of schizophrenia? (x2)
- Avolition
- Speech poverty
What is avolition?
(Sometimes called apathy)
- Finding it difficult to begin or keep up with goal-directed activity (I.e actions performed in order to achieve a result).
- Andreason (1982) identified 3 identifying signs of avolition: poor hygiene and grooming, lack of persistence in work or education, lack of energy.
What is speech poverty (alogia)? (x4)
- Lessening of speech fluency and productivity, reflecting slow or blocked thoughts.
- Sometimes accompanied by a delay in the sufferer’s verbal responses during conversation.
- In DSM-5 it is a positive symptom.
- In ICD-10 it is a negative symptom.
What is a classification system?
A classification system collects the symptoms of a disorder.
Which symptoms are required for an ICD-10 based diagnosis of schizophrenia and for how long?
2 or more negative symptoms for one month.
Are positive symptoms required for an ICD-10 diagnosis?
Positive symptoms are not required.
What are the ICD-10 subtypes of schizophrenia?
- Paranoid (powerful delusions and hallucinations but few other symptoms).
- Hebrephrenic (involved primarily negative symptoms).
- Catatonic (involves disturbance to movement).
(The ICD-11 no longer recognises subtypes).
Which symptoms are required for a diagnosis of schizophrenia using DSM-5 and for how long?
2 or more of the following for at least one month, and at least one of them must be a positive symptom (1, 2 or 3).
1. Delusions
2. Hallucinations
3. Disorganised speech
4. Grossly disorganised or catatonic behaviour
5. Negative symptoms, such as diminished emotional expression
What are the additional criteria for a schizophrenia diagnosis?
- Impairment in one of the main areas of functioning for a significant period of time since the onset of disturbance (work, interpersonal relations or self-care).
- Some signs of the disorder must last for a continuous period of at least 6 months.
- Schizoaffective disorder and bipolar or depressive disorder must be ruled out:
- No major depressive or manic episodes occurred concurrently with active phase symptoms.
- If mood episodes (depressive or manic) have occurred during active phase symptoms, they have been present for a minority of the total duration of the active and residual phases of the illness.
- If there is a history of autism spectrum disorder, delusions or hallucinations (along with other symptoms) should be present for at least one month for a diagnosis to be made.
What are the main differences between ICD-10 and DSM-5? (x2)
- DSM-5 states that some signs must be present for 6 months, but ICD-10 states that one month is enough.
- DSM-5 states that there must be one positive symptom, but ICD-10 states that 2 negative symptoms are enough.
What is the impact of the differences in the classification systems?
This poses challenges with reliability and validity.
What is reliability in relation to schizophrenia?
The extent to which the diagnosis of schizophrenia is consistent - the level of agreement between psychiatrists and diagnostic tools over time.
