Schizophrenia Flashcards
Major psychological disorder
Severe Mental Illness (SMI)
“Schiz” means splitBetween thoughts and reality
Between thoughts and reality
␣ NOT between 2 separate minds ␣ NOT Dissociative Identity Disorder
Profound in its consequences
Impaired thought processes
␣ Misperceptions of the environment ␣ General life functioning usually quite impaired ␣ Impaired concentration ␣ Problems with motor activity ␣ Abnormal emotional style
Diagnostic Criteria Schiz
Problems present for at least 6 months
␣ Must be active period with psychotic episode for at least one month
␣ Course may or may not include a prodromal stage
␣ Cannot be due to a substance ␣ Very important differential diagnosis
The Course of Schizophrenia:
ot every patient diagnosed with schizophrenia manifests symptoms for life
ven though diagnostically will always carry diagnosis [schizophrenia, residual type]
Historically, used one-third rule
1/3 deteriorate for life ␣ 1/3 have chronic episodes of schizophrenia ␣ 1/3 show substantial improvement
Research on Relapse and Remission
5-year follow-up research results ␣ Zubin et al., 1989
22% one episode Research on Relapse and Remission
Group 1: One episode only; no impairment and improved
functioning (22%)
78% several episodes and varying degrees of
lasting impairment Group 2:Research on Relapse and Remission
Several episodes with minimal impairment
35%
Group 3:Research on Relapse and Remission
Impairment after single episode and increased impairment later (no return to normality) (8%)
Group 4: Research on Relapse and Remission
Impairment increasing after several episodes (no return to normality) (35%)
Gender Differences
Roughly similar prevalence rates for men and women
␣ Males diagnosed much earlier in life then rates decrease
␣ Women more frequently diagnosed later in life
␣ Age of onset has potential prognostic value
Symptoms of Schizophrenia1/2
No single feature seen invariably or only in schizophrenia
␣ No pathognomonic sign
␣ A constellation of features must exist for a diagnosis of schizophrenia to be made
␣ Talk about as positive and negative symptoms
Symptoms of Schizophrenia 2/2
Two (or more) during a 1-month period ␣ Delusions
␣ Hallucinations ␣ Disorganized speech ␣ Grossly disorganized or catatonic behavior ␣ Negative symptom
Negative Symptoms
correlated with more problems ␣ Higher rates of permanent disability
␣ Affective flattening ␣ Alogia ␣ Avoiltion ␣ Apathy
␣ Anhedonia ␣ Asociality
Thought Disorders
positive symptom
␣ Considered a “hallmark” of schizophrenia
␣ Remember NO pathognomonic signs! ␣ Thought disorders manifest in
␣ Content and/or ␣ What the thought is about
␣ Form ␣ How the production of thought appears
Thought disorders of Content
Major feature is presence of delusions ␣ False, fixed beliefs
␣ Not based in reality ␣ Maintained in the light of overwhelming
evidence to the contrary ␣ Many types of delusions
Delusion of persecution
Perhaps most common ␣ Belief that agency, group, or individual is out to
get person
Delusion of grandiosity
Person is extremely special, capable of special
feats ␣ Not based in reality ␣ Example: God, Christ, etc.
Delusion of reference
Events, objects, or people given unusual
significance ␣ . e.g., Nurse may be the Angel of Death
18
Delusions: Thought broadcasting
person believes can send thoughts to
minds of others
Delusion: Thought insertion
Belief that thoughts are being inserted into
one’s mind from some external source
Thought removal or extraction:
Belief that external agent is removing thoughts from one’s brain or head
Formal thought disorders
How the thought is expressed
