Schizophrenia 1
‘Positive’ symptoms
o Additional to normal experience and behaviour
o Psychosis – delusions, hallucinations and thought disorder
‘negative’ symptoms
o Lack or decline in normal experience or behaviour
Inappropriate or non-present emotion, poverty of speech and lack of
motivation
3 semi-independent factors/three-factor model
o Hallucinations and delusions
Reality distortions
Can occur in any modality, typically auditory (hearing voices)
o Negative symptoms
Psychomotor poverty, flattened affect
o Disorganized
Disorganized behaviour, inappropriate affect
DSM5
o Criterion A – characteristic symptoms:
2+ of following present for significant portion of time during 1 month period
(at least 1 of first 3)
Delusions
Hallucinations
Disorganized speech
Grossly disorganized or catatonic behaviour (abnormal psychomotor
behaviour)
o Criterion B – social/occupational dysfunction:
One or more major areas of functioning are markedly below level achieved
prior to onset for a significant portion of time
o Criterion C – duration:
At least 6 months
o Criterion D – schizoaffective and mood disorder exclusion
o Criterion E – substance exclusions
Not due to drug/medication
o Criterion F – relationship t global development delay or ASD
Controversies from DSM-4
o Ignores cognitive symptoms despite:
Decreased IQ, loss of recall, recognition memory, working memory,
impairment in executive control
Problems with attention, info processing, eye movements
o Lack of clear distinctions between various subtypes
Poor diagnostic stability over time
Controversies from DSM-5
o Can’t be measured objectively
o Cognitive changes not added to characteristic symptoms
Risk factors
o Gender – lower age for males at first episode (24.5 vs 28)
‘Positive’ symptoms
o Additional to normal experience and behaviour
o Psychosis – delusions, hallucinations and thought disorder
‘negative’ symptoms
o Lack or decline in normal experience or behaviour
Inappropriate or non-present emotion, poverty of speech and lack of
motivation
3 semi-independent factors/three-factor model
o Hallucinations and delusions
Reality distortions
Can occur in any modality, typically auditory (hearing voices)
o Negative symptoms
Psychomotor poverty, flattened affect
o Disorganized
Disorganized behaviour, inappropriate affect
DSM5
o Criterion A – characteristic symptoms:
2+ of following present for significant portion of time during 1 month period
(at least 1 of first 3)
Delusions
Hallucinations
Disorganized speech
Grossly disorganized or catatonic behaviour (abnormal psychomotor
behaviour)
o Criterion B – social/occupational dysfunction:
One or more major areas of functioning are markedly below level achieved
prior to onset for a significant portion of time
o Criterion C – duration:
At least 6 months
o Criterion D – schizoaffective and mood disorder exclusion
o Criterion E – substance exclusions
Not due to drug/medication
o Criterion F – relationship t global development delay or ASD
Controversies from DSM-4
o Ignores cognitive symptoms despite:
Decreased IQ, loss of recall, recognition memory, working memory,
impairment in executive control
Problems with attention, info processing, eye movements
o Lack of clear distinctions between various subtypes
Poor diagnostic stability over time
Controversies from DSM-5
o Can’t be measured objectively
o Cognitive changes not added to characteristic symptoms
Risk factors
o Gender – lower age for males at first episode (24.5 vs 28)
