Schizophrenia - Clinical Characteristics

  • 1% chance
  • usually aged 15-45
  • 50/50% males and females

1. chronic onset - gradual loss of motivation, deteriration, signs of disturbance, deulusional ideas/hallucinations

2. acute onset - obvious hallucinations (usual after stressfull period), very disturbed  behavious withing few days



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Schiz - Issues of classifications and diagnosis -


  • little consistency in diagnosis = DSM was very broad before in USA
  • low reliability in diagnosis = many differences in classificiation + vague DSM   = wrong treatment

First-rank Symptoms (FRS)

  • Kurt Schneider (1959) - 'first rank symptoms' = symptoms only for schiz
  • FRS - basis for current ICD-10

Differences between ICD-10 + DSM-TR-IV

  • ICD - symptoms for 1 month, DSM - symptoms for 6 months
  • ICD - more emphasis on FRS, DSM - more emphasis on course of disorder + accompanying functional impairment
  • DSM - multi-axial (=various factors considered before diagnosis)
  • Classification systems: ICD - 7 subtypes, DSM - 5 subtypes
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Criteria for Diagnosis -many different criteras = often wrong diagnosis + treatment

Different types of Schizc (ICR)

  • Paranoid schiz - mainly delusions/hallusinations
  • Hebephrenic schiz - disorganised aimless behaviour, rambling incoherent speech
  • Catatonic schiz - motor abnormality, strang posture etc
  • Undifferentiated schiz - general category if belong to none of others
  • Post-schiz depression (NOT IN DSM) - schiz behaviour within 12 months, signs of depression, no schiz
  • Residual schiz - schiz behavious 12+ months ago, not now
  • Simple schiz (NOT IN DSM) - slow progressive development (1+year) of social withdrawal, apathy, poverty of speech, slowly more stupid

Type 1 syndrome - acute, positive symptoms (addictions/exaggerations of normal thought/behaviour) - hallucinations, delusions, disorganised speech

Type 2 syndrome - chronic, negative symptoms, flattening of affect, apathy

  • Type 1 + 2 - ppl dont fit neatly into just one, however, different types have different causes
  • Blurred distinction - some ppl diagnosed with one, later develop others = weaken reliability of diagnosis
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Schiz - Issues of classifications and diagnosis -

Do these different types of schiz actually exist?

Schiz-like disorders - Ppl with schiz symptoms that don't exactly meet critera, so now other variations os schiz in ICD + DSM 

Dimensional or Categorical Disorder? - Should be graded on number of symptoms to determine degree of schiz, not just the category

Schiz as a multiple disorder - if just 2 very random symptoms needed to be schiz = no casual underlying factor = so should make each type of schiz its own disorder and treatment

Differential diagnosis - Symptoms of temporal lobe epilepsy - very similar to schiz, easy to diagnose wrong condition completely

Dual diagnosis - If schiz + depressed, both schiz + depression need to be diagnosed + treated - however, wrong diagnois if classed as one disorder

Cultural variations - More common in black ppl - ? due to genetic vunerability, psychosocial factors because small minority, or misdiagnosis? ...or because clinicans think cultural differences are schiz behaviour

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