A psychotic disorder characterised by distorted thinking, impaired emotional responses, poor interpersonal skills and a distortion of reality.
- THOUGHT WITHDRAWL: unwanted insertion of thoughts
- THOUGHT BROADCAST: broadcast of private thoughts
- THOUGHT ECHO/ INSERTION.
- DELUSIONS OF CONTROL/INFLUENCE/PASSIVITY: don't believe in control of own thoughts etc.
- HALLUCINATORY VOICES: seemingly real voices.
- PERSISTANT HALLUCINATIONS: perceptions occurring without external stimuli.
- INCOHERENT SPEECH/ NEOGLISMS: made up words, jumbled speech.
- CATATONIC BEHAVIOUR: unusual body movements.
- NEGATIVE SYMPTOMS: loss of emotion/ interest/ motivation.
1 symptom in Group 1 or at least 2 symptoms in Group 2 must be present for:
DSM (USA) - 6 months. ICD (UK) - 1 month.
Subtypes of Schizophrenia
Characterised by DELUSIONS,HALLUCINATIONS, DISORGANISED SPEECH
Unusual MOTOR ACTIVITY, AGITATION, extreme NEGATIVISM
Evident from early age.DISORGANISED speech, INAPPROPRIATE effect
When schizo symptoms PRESENT but do not fit in to any category
1 ep of Schizo experienced in the past. But no longer exhibiting signs
Course of disorder.
Schizophrenia is marked by GRADUAL WITHDRAWL from society and GRADUAL LOSS of PLEASURE in activities and FLAT AFFECT.
AGE OF ONSET: Usually EARLY ADULT LIFE. (peak age for women 5-10 years later than men)
Periods of PSYCHOTIC DISTURBANCE with NORMAL periods.
Changes in MOOD/ BEHAVIOUR evident.
Psychotic stage lasting 1-6 months to a year.
Inter-episode functioning has INDIVIDUAL DIFFERENCES.
BETTER inter-episode functioning = BETTER prognosis.
Reliability in Classification and Diagnosis.
Classification of an illness is only useful if its based on a RELIABLE system:
(In the US in 1930s only 20% diagnosed, rose to 80% in 1950s showing INCONSISTENCIES)
Differences in ICD and DSM:
- DSM requires 6 months. ICD only 1 month
- ICD emphasises SYMPTOMS. DSM focuses on COURSE of disorder.
- DSM is multi-axal
- DSM = 5 subtypes. ICD = 7 subtypes
DIFFCULT TO COMPARE DATA ON INDIVIDUALS DIAGNOSED WITH DIFF CRITERIA. could have diff disorders altogether.
BRITISH PSYCHOLOGISTS DISTINGUISH BETWEEN:
TYPE I syndrome: ACUTE disorder with POSITIVE symptoms
TYPE II syndrome: CHRONIC disorder with NEGATIVE symptoms
Validity of Classification and Diagnosis
Large number of CATEGORIES of Schizophrenia raises issue of VALIDITY.
argued Schizo should be seen as a dimensional disorder - reflecting DEGREES of problem.
BENTALL: term Schizo should be abandoned and each symptom viewed as a disorder in its own right.
difficult to distinguish between SUBTYPES and other disorders.
CO-MORBIDITY - diagnosed with one disorder but show symptoms of another.
diff rates among diff cultures.
I D A's
Classification system almost enitrley based on WHITE MIDDLE CLASS SOCIAL NORMS
BOYLE & BENTALL:
Concept of Schizo is neither RELIABLE nor VALID. So diagnosis is NOT CLINICALLY or SCIENTIFICALLY useful.