10A - Schizophrenia Spectrum Disorder
Tuesday, March 23, 2021
9:03 AM
*Mini-lecture 1 : Schizophrenia spectrum disorders
Schizophrenia: The "split mind"
A common misconception: Schizophrenia as "multiple personalities"
Eugen Blueler (1908)
o "I call dementia precox schizophrenia because … The splitting of the
[person's] different psychic functions is one of its most important features"
Associative splitting
Schizophrenia spectrum of disorders
*Mini-lecture 2 : Positive symptoms
Positive symptoms of schizophrenia
Positive symptoms add something to a person's experience. Include delusions and
hallucinations - distortions of reality. 50-70%
Hallucinations: sensory experiences without external stimuli as input
o Hallucinations are vivid, clear, and not under voluntary control
o Any sensory modality
auditory hallucinations most common -> Broca's Area very
active
Misinterpretation of inner speech, attributed to external
sources?
Delusions: Misrepresentations of reality, held without evidence
o Persecution: "Strangers on the street are undercover agents following me
o Referential: "Every song on this planet represents a truth about my life"
o Somatic: "My body is inhabited by aliens that devour my organs"
o Grandeur: "I have the power to change the course of history"
*Mini-lecture 3 : Negative symptoms
Negative symptoms of schizophrenia
Negative symptoms involve a lack or insufficiency of a normal behavior. Experienced by
approximately 25%
o Avolition: Unable to initiate or persist in activities (apathy)
, o Alogia: Relative absence of speech
Short relies, seems uninterested in conversation
o Anhedonia: Lack of pleasure; indifference to activities
o Asociality: Severe deficits in social functioning
o Affective flattening: Lack of expected emotional responses
*Mini-lecture 4 : Disorganized symptoms
Disorganized symptoms of schizophrenia
Disorganized symptoms involve a severe disruption in speech, behavior, and/or emotion.
Prevalence unclear
Disorganized speech: Impairment in effective communication
o Tangentially; derailment; "word salad"
Disorganized behavior: Variety of unusual, erratic behaviors
o Difficulties with goal-directed behavior
o Catatonia: Reduction in motor activity; random, erratic movements
Motor dysfunction ranging from agitation to immobility
Inappropriate affect: Mismatch between affect and situation
*Mini-lecture 5 : Schizophrenia - Clinical description
People with the same diagnosis might experience it in completely different ways with any
number and any combination of symptoms
Schizophrenia - DSM5
Two or more of these five characteristic symptoms. At least one must be delusions,
hallucinations, or disorganized speech
Impairment in functioning for a significant portion of the time (work; relationships; slef
care…)
Continuous signs for at least 6 months; at least one month of Criterion A symptoms
(shorter if successfully treated)
o May experience periods of prodromal/residual symptoms
Differential diagnosis: Schizoaffective/mood disorder; substance/medical condition; ASD
or communication disorder
Specifier: With catatonia
Tuesday, March 23, 2021
9:03 AM
*Mini-lecture 1 : Schizophrenia spectrum disorders
Schizophrenia: The "split mind"
A common misconception: Schizophrenia as "multiple personalities"
Eugen Blueler (1908)
o "I call dementia precox schizophrenia because … The splitting of the
[person's] different psychic functions is one of its most important features"
Associative splitting
Schizophrenia spectrum of disorders
*Mini-lecture 2 : Positive symptoms
Positive symptoms of schizophrenia
Positive symptoms add something to a person's experience. Include delusions and
hallucinations - distortions of reality. 50-70%
Hallucinations: sensory experiences without external stimuli as input
o Hallucinations are vivid, clear, and not under voluntary control
o Any sensory modality
auditory hallucinations most common -> Broca's Area very
active
Misinterpretation of inner speech, attributed to external
sources?
Delusions: Misrepresentations of reality, held without evidence
o Persecution: "Strangers on the street are undercover agents following me
o Referential: "Every song on this planet represents a truth about my life"
o Somatic: "My body is inhabited by aliens that devour my organs"
o Grandeur: "I have the power to change the course of history"
*Mini-lecture 3 : Negative symptoms
Negative symptoms of schizophrenia
Negative symptoms involve a lack or insufficiency of a normal behavior. Experienced by
approximately 25%
o Avolition: Unable to initiate or persist in activities (apathy)
, o Alogia: Relative absence of speech
Short relies, seems uninterested in conversation
o Anhedonia: Lack of pleasure; indifference to activities
o Asociality: Severe deficits in social functioning
o Affective flattening: Lack of expected emotional responses
*Mini-lecture 4 : Disorganized symptoms
Disorganized symptoms of schizophrenia
Disorganized symptoms involve a severe disruption in speech, behavior, and/or emotion.
Prevalence unclear
Disorganized speech: Impairment in effective communication
o Tangentially; derailment; "word salad"
Disorganized behavior: Variety of unusual, erratic behaviors
o Difficulties with goal-directed behavior
o Catatonia: Reduction in motor activity; random, erratic movements
Motor dysfunction ranging from agitation to immobility
Inappropriate affect: Mismatch between affect and situation
*Mini-lecture 5 : Schizophrenia - Clinical description
People with the same diagnosis might experience it in completely different ways with any
number and any combination of symptoms
Schizophrenia - DSM5
Two or more of these five characteristic symptoms. At least one must be delusions,
hallucinations, or disorganized speech
Impairment in functioning for a significant portion of the time (work; relationships; slef
care…)
Continuous signs for at least 6 months; at least one month of Criterion A symptoms
(shorter if successfully treated)
o May experience periods of prodromal/residual symptoms
Differential diagnosis: Schizoaffective/mood disorder; substance/medical condition; ASD
or communication disorder
Specifier: With catatonia
