Schizophrenia

General Background..

Perceptual symptomsAuditory hallucinations – hearing things that are not there. People often hear voices saying abusive or critical things.Sometimes people see, smell or taste things that are not there.

Social symptoms

Social withdrawal- not taking part in or

enjoying social situations. In some cases people might

be aloof or avoid eye contact.

Cognitive symptoms

Delusions – believing things that are not

true. People can have delusions of grandeur (where

they believe they are more important than they are

e.g. that they are the KING) or of a paranoia and

persecution (where they believe that their

behaviour is being controlled by someone or

something else).

Cognitive symptoms continued

Thought control – believing that

your thoughts are being controlled e.g. thought

insertions is where people feel that someone is

putting thoughts into their heads. Withdrawal is when

they believe that someone is removing their thoughts.

They might also believe that people can read their

thoughts (this is called broadcasting).

Cognitive symptoms continued

Language impairments –

irrelevant and incoherent speech. People often

show sighs of cognitive distractibility where they

cannot maintain a train of thought. They might

also repeat sounds (echolalia), jumble their words

(word salad), make nonsensical rhymes (clang

associations) and invent words (neologisms)

Affective/Emotional symptoms

Depressive symptoms – a lack of energy

and interest in things especially in personal care and

hygiene.

Lack of emotion – not reacting to typically

emotional situations. This is also called emotional blunting.

Inappropriate emotions- reacting in an

inappropriate way. E.g. laughing at bad news.

Behavioural Symptoms

Stereotyped behaviours- continuously

repeating actions which are often strange and do not

have a purpose.

Psychomotor disturbance – not having

control of your muscles. People may experience

catatonia, where they sit in an awkward position for a

long time. In this state people will sometimes stay in

whatever position they are put in (so if you lift their arm

over their head it will stay like that until you move it

back).

Behavioural Symptoms continued

Catatonic stupor- lying rigidly and not moving for long periods of time. People are conscious during these episodes and can remember what was going on around them although they do not seem aware of it at the time.

Symptoms

Type 1 – Positive symptoms–Auditory hallucinations–Delusions–Thought control–Language problems, e.g. jumbled speech.

Type 2- Negative

symptoms. This is where people do not display

‘normal’ behaviours for example;

–Withdrawn

–Unresponsive

–lack of emotion/affection

Watch the video and state which sub-category best describe Gerard’s’ symptoms & why?

The DSM-IV

The DSM-IV (the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders) contains a list of mental health disorders. Individuals are rated on a multiple axes/dimensions and diagnostic categories are used.

DSM-IV continued

For a person to be diagnosed with schizophrenia, the DSM-IV states that their symptoms must significantly impair reality testing - the ability to function in the real world. The symptoms have to have been present for at least six months.

The DSM-IV aims to give a diagnosis which has both reliability and validity. These factors are however not always easy to achieve.

Watch the DVD (approximately one hour long) – How mad are you?

Find out how easy it is to diagnose mental Illness. This programme last about an hour,

THE ICD-10

Considers the following groups of symptoms important there is a minimum requirement for at least one of the symptoms listed under one or two to be present for a period of at least one month.

NB: that the examples given to illustrate the symptoms are included here for the purpose of clarification but are not included in the ICD list of symptoms.

THE ICD-10 continued

Section one of the ICD-10 – part (a) Thought control. There are a number of

different types. These are; Thought withdrawal - thoughts are being

extracted from the person’s mind Thought insertion – unwelcome thoughts

are being inserted into the person’s mind. Thought broadcast – private thoughts

have become accessible to other people.

THE ICD-10 continued

Section one of the ICD-10 – part (b)

Delusions of control influence and passivity - a delusion is a distorted belief. The individual does not feel in control of their own thoughts, feelings and will (that is the ability to make things happen).

THE ICD-10 continued

Section one of the ICD-10 – part (c)

Hallucinatory voices – these are voices that do not exist but feel real to the person hearing them. The content of the voices is very variable but often takes the form of a running commentary on the person’s behaviour.

THE ICD-10 continued

Section one of the ICD-10 – part (d)

Other persistent delusions – these are distorted beliefs that are culturally inappropriate or involve impossible powers and capabilities (e.g. believing themselves to be great politicians or religious leaders)

 

THE ICD-10 continued

Section two of the ICD-10 – part (a)

Persistent hallucinations- these are distorted perceptions arising from any of the senses they are however usually auditory.

THE ICD-10 continued

Section two of the ICD-10 – part (b)

Incoherent or irrelevant speech- which can be either be so jumbled that it is meaningless or an individual starts to use made up words (neologisms).

THE ICD-10 continued

Section two of the ICD-10 – part (c)

Catatonic behaviour- the adoption of unusual body movements or postures which are often keep for a period of time.

THE ICD-10 continued

Section two of the ICD-10 – part (d)

Negative symptoms - these include apathy and a general lack of drive or motivation.

Dustbin game

Symptoms of schizophrenia

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