STUDY GUIDE: CHAPTERS 13, 14, AND 15
Chapter 13: Schizophrenia and Other Psychotic Disorders
I. Overview of Schizophrenia
• Definition: Schizophrenia is a chronic mental health disorder
characterized by distorted thinking, altered perceptions, and impaired behaviors.
• Patients may experience a break from reality and severe impairments in
relationships, employment, and daily functioning.
Psychosis
• A defining feature of schizophrenia, psychosis involves:
o Delusions: False, fixed beliefs.
o Hallucinations: Perceptual disturbances that are not based on external
stimuli.
Prevalence
• Affects 0.5%–1% of the population globally.
• Higher prevalence among individuals in urban areas, those experiencing
homelessness, and populations with lower socioeconomic status.
Onset and Gender Differences
• Onset Age:
o Men: Symptoms often begin in the early to mid-20s.
o Women: Symptoms typically present in the late 20s or early 30s, with
milder forms being more common.
,Impact on Life Course
• Prognosis:
o 1/3 require long-term care.
o 1/3 experience episodic symptoms but can manage with treatment.
o 1/3 recover after a single episode but rarely return to pre-illness
functioning.
II. DSM-5 Criteria for Schizophrenia
• To diagnose schizophrenia, two or more symptoms must be present for at
least one month, and the overall disturbance must persist for six months.
1. Delusions
2. Hallucinations
3. Disorganized Speech
4. Grossly Disorganized or Catatonic Behavior
5. Negative Symptoms
III. Symptoms of Schizophrenia
1. Positive Symptoms
• Delusions: False beliefs held despite contradictory evidence.
o Examples:
o Persecution: Belief that one is being targeted or harassed (e.g.,
“The government is spying on me”).
o Grandeur: Belief in having exceptional abilities or status (e.g., “I
am a prophet”).
o These distortions reflect an overactive dopamine system.
• Hallucinations: Sensory experiences without external stimuli.
• Auditory hallucinations are the most common (e.g., hearing voices
commenting on one’s actions).
, • Other types:
o Visual hallucinations: Seeing things that are not there.
o Tactile hallucinations: Feeling sensations like insects crawling on the
skin.
• Disorganized Speech:
o Word salads: Jumbled words that lack logical connections.
o Example: “Blue sun running fast under light sound.”
2. Negative Symptoms
• Represent deficits in normal functioning:
o Anhedonia: Inability to feel pleasure.
o Avolition: Lack of motivation or initiative.
o Flat Affect: Reduced emotional expression, such as speaking in a
monotone voice.
o Alogia: Minimal verbal communication.
3. Cognitive Symptoms
• Attention deficits: Difficulty focusing or filtering information.
• Memory impairments: Challenges with working memory.
• Social cognition impairments: Difficulty interpreting emotions or social
cues.
IV. Types of Psychotic Disorders
1. Schizoaffective Disorder
• Features a combination of schizophrenia and mood disorder
symptoms, such as depression or mania.
2. Schizophreniform Disorder
Chapter 13: Schizophrenia and Other Psychotic Disorders
I. Overview of Schizophrenia
• Definition: Schizophrenia is a chronic mental health disorder
characterized by distorted thinking, altered perceptions, and impaired behaviors.
• Patients may experience a break from reality and severe impairments in
relationships, employment, and daily functioning.
Psychosis
• A defining feature of schizophrenia, psychosis involves:
o Delusions: False, fixed beliefs.
o Hallucinations: Perceptual disturbances that are not based on external
stimuli.
Prevalence
• Affects 0.5%–1% of the population globally.
• Higher prevalence among individuals in urban areas, those experiencing
homelessness, and populations with lower socioeconomic status.
Onset and Gender Differences
• Onset Age:
o Men: Symptoms often begin in the early to mid-20s.
o Women: Symptoms typically present in the late 20s or early 30s, with
milder forms being more common.
,Impact on Life Course
• Prognosis:
o 1/3 require long-term care.
o 1/3 experience episodic symptoms but can manage with treatment.
o 1/3 recover after a single episode but rarely return to pre-illness
functioning.
II. DSM-5 Criteria for Schizophrenia
• To diagnose schizophrenia, two or more symptoms must be present for at
least one month, and the overall disturbance must persist for six months.
1. Delusions
2. Hallucinations
3. Disorganized Speech
4. Grossly Disorganized or Catatonic Behavior
5. Negative Symptoms
III. Symptoms of Schizophrenia
1. Positive Symptoms
• Delusions: False beliefs held despite contradictory evidence.
o Examples:
o Persecution: Belief that one is being targeted or harassed (e.g.,
“The government is spying on me”).
o Grandeur: Belief in having exceptional abilities or status (e.g., “I
am a prophet”).
o These distortions reflect an overactive dopamine system.
• Hallucinations: Sensory experiences without external stimuli.
• Auditory hallucinations are the most common (e.g., hearing voices
commenting on one’s actions).
, • Other types:
o Visual hallucinations: Seeing things that are not there.
o Tactile hallucinations: Feeling sensations like insects crawling on the
skin.
• Disorganized Speech:
o Word salads: Jumbled words that lack logical connections.
o Example: “Blue sun running fast under light sound.”
2. Negative Symptoms
• Represent deficits in normal functioning:
o Anhedonia: Inability to feel pleasure.
o Avolition: Lack of motivation or initiative.
o Flat Affect: Reduced emotional expression, such as speaking in a
monotone voice.
o Alogia: Minimal verbal communication.
3. Cognitive Symptoms
• Attention deficits: Difficulty focusing or filtering information.
• Memory impairments: Challenges with working memory.
• Social cognition impairments: Difficulty interpreting emotions or social
cues.
IV. Types of Psychotic Disorders
1. Schizoaffective Disorder
• Features a combination of schizophrenia and mood disorder
symptoms, such as depression or mania.
2. Schizophreniform Disorder