Component 3- Schizophrenia

Question 1

Characteristics: What is schizophrenia?

Answer 1

• lifelong. psychotic illness that affects around 1% pop
• symptoms cause individual to lose touch w/ reality
• lifelong, can be treated but no cure. patients will typically suffer episodes of severe symptoms and periods being symptom free
• schizophrenics typically not dangerous. Increased risk of violence but risk schizophrenics pose to public is minimal and media exaggerates this
• no known single cause and is likely to ne caused by multiple interacting factors
• most schizophrenics have difficulty accepting diagnosis as they believe delusions and/or hallucinations real or do not have adequate language skills to fully express beliefs.
• experience of illness differs between different people

Question 2

How did Kurt Schneider (1959) suggest categorising the symptoms of schizophrenia?

Answer 2

Individuals with schizophrenia will vary substantially on most features of the disorder.

Schneider suggested categorising the symptoms into positive and negative symptoms:
Positive: symptoms/behaviours individual shows in addition to typical behaviours, so if they did not have SCh, they would not have symptom. Hallucinations, delusions and disordered thinking

Negative: symptoms/behaviours that inhibit those with Sch from showing typical behaviours such as being able to hold a conversation. Alogia, avolition, andhedonia, flatness or affect and catatonic behaviour

Question 3

Delusions

Answer 3

• fixed beliefs that are not true
• content may include a variety of themes including religion, somatic, persecution (most common), grandiose etc.
• persecution (belief one will be harmed, harrassed by person, group/organisation)
• grandiose (individual believes they have exceptional abilities, wealth or fame
• delusions are implausible and not understandable to same cultured peers and do not derive from ordinary life experiences
• example: someone has removed someone else’s organs and replaced them with another person’s without leaving any scars or wounds.(bizarre delusion
• example: one is under surveillance by the police, despite lack of evidence (non bizarre belief)

Question 4

Hallucinations

Answer 4

• perception-like experiences that occur without an external stimulus
• vivid, clear, with full force and impact as normal perceptions and not under voluntary control.
• auditory hallucinations most common, but may occur in any senses
• auditory usually experienced in voices whether familiar or unfamiliar, distinct from individual’s own thoughts

Question 5

Disorganised thinking (speech)

Answer 5

• typically inferred from speech
• switching from one topic to another (derailment or loose associations)
• answers to questions may be only loosely related or completely unrelated
• rarely speech may be so severely disorganised that it’s nearly incomprehensible
• may be severe enough to substantially impair effective communication
• less severe disorganised thinking/speech may occur in the prodromal periods of Sch

Question 6

Grossly disorganised or Abnormal Behaviour (including Catatonia)

Answer 6

• symptoms lead to difficulties performing everyday tasks
• catatonic behaviour is a decrease in reactivity to the environment. Resistance to instructions (negativism) to maintaining a rigid, inappropriate or bizarre posture, to a complete lack of verbal and motor responses (mutism and stupor). May also include purposeless and excessive motor activity for no reason (catatonic excitement).
• staring, grimacing, mutism, echoing speech
• catatonia is associated with Sch but may occur in other mental disorders

Question 7

Negative symptoms

Answer 7

• diminished emotional expression and avolition
• diminished emotional expression includes reductions in expressions of emotions in face, eye contact, intonation of speech and movements of the hand, head and face that normally emphasise emotions in speech
• avolition is a decrease in motivated self initiated purposeful activities.
• alogia, anhedonia, asociality
• alogia manifested by diminished speech
• anhedonia is the decreased ability to experience pleasure from positive stimuli or a degradation in the recollection of pleasure previously experienced
• asociality is the lack of interest in social interactions

Question 8

prodromal symptoms

Answer 8

• appears before the typical schizophrenic symptoms, particularly in young people. A prodrome of nonspecific symptoms appear, which is and early symptom indicating the onset of disease or illness. For those about to experience first episode of Sch, they may show prodromal symptoms in weeks and months before.
• loss of interest in usual activities
• avoiding others company
• staying away from school or work
• being irritable and oversensitive
• lack of interest in personal appearance and hygiene
• generalised anxiety
  mild degrees of depression
  these symptoms alone not enough to diagnose Sch as they are characteristics of other mental disorders such as depression or bipolar disorder. Only in retrospect once Sch has been diagnosed that these symptoms may be seen as the onset of the disorder.

Question 9

Diagnosis criteria

Answer 9

• a patient is assessed against set criteria to receive a diagnosis.
• In the UK and Europe, the criteria are laid out in the ICD-10. Medical classification list by the World Health Organisation (WHO)
• In the USA, the DSM-5 is used. Diagnostic and Statistical Manual of Mental Disorders and is published by the American Psychiatric Association (APA)
• both systems aim to clarify symptoms of illnesses to enable medical professionals to diagnose patients
• a lot of overlap between the two systems
• some differences, so an individual may receive a diagnosis for an illness with one criteria but not the other
• While DSM focusses exclusively on mental illness, ICD has a wider scope and includes physical illness
• both systems could be argued to be culturally biased. Created in west and are based on western ideals of mental health. The research that the systems are based on are predominantly conducted in western countries.