symptoms of schizophrenia Flashcards
four key symptoms of schizophrenia
- thought insertion
- hallucinations
- delusions
- disordered thinking
diagnosing schizophrenia
- the DSM-5 requires at least 2 out of the 4 key symptoms - one must be delusions, hallucinations or disorganised speech / thought but the patient may also have grossly disorganised or catatonic behaviour and / or negative symptoms (diminished e,otional expression, avolition, alogia, anhedonia and asociality)
- the patients has to experience the symptoms for at least a month and experienced distrubance to everyday functioning for at least 6 months
- in the ICD-10 there is less focus on dysfunciton and 6 months of being distured is not necessary for a diagnosis to be made
thought insertion
- when a person believes their thoughts do not belong to them and have been implanted by an external source
- they experience a ‘blurring’ of the boundary between the self and others and feel that this border has beocme permeable
- this can lead to the belief that thoughts, feelings and experiences can pass from one person to another
types of delusions
- delusions of persecution
- delusions of reference
- delusions of grandeur
- erotomanic delusions
- delusions of nihilism
- somatic delusions
delusions
- fixed beliefs that are resistant to change and implausable to people of the same cultural background
- they may relate to everyday life (e.g., believing that your movements are being monitored by the police) or they may be ‘bizarre’ (e.g., believing that an alien is trying to remove your brain)
delusions of persecution
belief that one is going to be harmed or harassed by an individual, organisation or other group
delusions of reference
belief that certain gestures, comments and environmental cues are directed at one self
delusions of grandeur
when an individual believes that he or she has exeptional abilities, wealth or fame
erotomanic delusions
when an individual believes falseley that another person is in love with him or her
delusions of nihilism
the conviction that a major catastrophe will occur
somatic delusions
focus on preoccupations regarding health and organ function
type of hallucinations
- auditory hallucinations
- visual hallucinations
hallucinations
perceptual experiences which do not correspond with reality
auditory hallucinations
usually experienced as voices, that are percieved as distinct from the individuals own thoughts
visual hallucinations
seeing things which aren’t actually there
disordered thinking
- jumbled and unrelated thoughts leading to incoherent speech
- the person may switch from one topic to another and jumble seemingly unrelated ideas making it difficul to follow their train of thought
types of disordered thinking
- derailment / loose associations
- tangentiality
- word salad
derailment / loose association
the individual may switch from one topic to another
tangentiality
answers to queestions may be onbliquely related or completely unrelated
word salad
speech may be so severely disorganised that it is nearly incomprehensive and resembles receptive aphasia in its linguistic disordanisation
grossly disorganised behaviour / catatonia
behaviour ranging from child-like silliness to unpredictable agitation
behaviours associated with grossly disorganised behaviour / catatonia
resistance to instructions, maintaining a rigid inapproriate or bizarre posture, a complete lack or verbal or motor responses
positive symptoms of schizophrenia
- delusions
- hallucinations
- disorganised thinking
- thought insertion
- grossly disorganised behaviour / catatonia
negative symptoms of schizophrenia
- diminished emotional expression
- avolition
- alogia
- anhedonia
- asociality
diminished emotional expression
includes reductions in the expression of emotions in the face, eye contact, intonation of speech and movements of the hand, head and face that normally give an emotional emphasis to speech
avolition
a decrease in motivated self-intitated purposeful activities
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algolia
manifested by diminished speech output
anhedonia
the decreased ability to experience pleasure from pistive stimuli or degredation in the recollection of pleasure previously experienced
asociality
refers to the lack of interest in social interactions and may be associated with avolition, but it can also be a manifestation of limited oppourtunities for social interactions
features of schizophrenia - life time prevalence
- the lifetime prevalance which is 0.3-0.7%
- this varies with ethnicity, nationality and geographic origin in immigrants
- onset is slightly earlier in males (early to mid 20s) than females (late 20s)
- males tend to have a poorer prognosis than females
- females are over-represented in late onset cases (40+)
features of schizophrenia - prognisis
- prognosis is variable and hard to predict
- a minority recover completely, but most experience chronic, episodic impairment and some show progressive deterioration, with increasingly brief periods of remission and severe cognitive deficits
- positive symptoms reduce over time but debilitating negative symptoms often remain
