Schizophrenia

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)