Introduction to schizophrenia

Question 1

What are the percentages of schizophrenia?

Answer 1

• Around 1.1% of the population have schizophrenia
• With drug treatment, 40% of people with schizophrenia suffer a relapse
• After 10 years, 25% recover fully and 15% will be hospitalised

Question 2

What are the 2 types of symptoms of schizophrenia?

Answer 2

1. Positive
2. Negative

Question 3

What are the positive symptoms?

Answer 3

1. Hallucinations
2. Delusions
3. Disorganised thinking and speech

Question 4

What are hallucinations?

Answer 4

• They may not have any identifiable source
• The most commonly reported types are auditory and visual
• The less common types are olfactory and tactile

Question 5

What are delusions?

Answer 5

• They are not based on facts and evidence that are very difficult to disprove
• There are many types of delusion, including those of persecution and control

Question 6

What is disorganised thinking and speech?

Answer 6

• Makes it hard to concentrate on anything
• Thoughts drift from 1 thing to another although there’s no connection between them
• Thoughts may be described as misty or hazy
• People will have trouble finishing reading or watching something and may struggle with work
• Words may also become jumbled or confused, making it difficult for others to understand

Question 7

What are the negative symptoms?

Answer 7

1. Speech poverty (alogia)
2. Lack of emotion (flat effect)
3. Avolition (social withdrawal)
4. Apathy
5. Inappropriate effect

Question 8

What is speech poverty?

Answer 8

• Reduction in communication is thought to result from the slowing/blocking of thoughts
• Often manifested as short, empty replies to questions
• The patient has difficulty starting a conversation or finds it hard to speak to people

Question 9

What is lack of emotion?

Answer 9

• A reduction of emotions
• The range and intensity of facial expressions, tone of voice and eye contact are reduced
• Body language becomes difficult to interpret

Question 10

What is avolition?

Answer 10

• Difficulty in planning and setting goals
• No interest in socialising or hobbies
• A person doesn’t want to do anything and will sit in the house for hours or even days

Question 11

What is apathy?

Answer 11

• Lack of motivation
• Neglecting household chores leading to poor grooming and hygiene and a low sex drive

Question 12

What is inappropriate effect?

Answer 12

Emotional expressions are unsuitable for the situation, such as laughing at serious things

Question 13

What is the diagnostic criteria for classifying schizophrenia?

Answer 13

1. Characteristic symptoms
2. Social/occupational dysfunction
3. Duration
4. Schizoaffective and mood disorder exclusion
5. Exclusion of known organic causes
6. Relationship to autistic spectrum disorder (if any)

Question 14

What are characteristic symptoms?

Answer 14

Two (or more) of the following are present for 1 month:

• Must have at least 1 of: delusions, hallucinations, disorganised speech (positive symptoms)
• Grossly disorganised or catatonic behaviour
• Negative symptoms

Question 15

What is social/occupational dysfunction?

Answer 15

For a significant portion of the time since the onset of the disturbance, level of functioning in 1 or more major areas: work, relationships, self care

Question 16

What is duration?

Answer 16

Have permitted for at least 6 months and at least 1 month of symptoms

Question 17

What is schizoaffective and mood disorder exclusion?

Answer 17

Ruled out because the patient has not experienced any depressive, manic or mixed episodes at the same time as category A symptoms

Question 18

What is exclusion of known organic causes?

Answer 18

The disturbance is not due to physiological effects of a substance

Question 19

What is the relationship to the autistic spectrum?

(Diagnostic criteria for classifying schizophrenia)

Answer 19

Additional diagnosis of schizophrenia is only made if the patient shows hallucinations or delusions