Schizophrenia

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Schizophrenia (psychopathology) - Characteristics

A term that refers to either the study of mental illness or mental distress, or the manifestation of behaviours and experiences which may be indicative of mental illness or psychological impairment, such as abnormal, maladaptive behaviour, emotions and thoughts.  Psychiatrists and clinical psychologists are particularly interested in this area and may either be involved in clinical treatment, research or development and manifestations.

Why study psychopathology? It is one of the earliest forms of psychopathology, it has always been of an interest to look at mental illnesses as well as help those suffering.

Anti-psychiatry:

Refers to the theories that emerged in the 60’s about the fundamental assumptions and practises of psychiatry, there are two central contentions of the anti-psychiatry movement:

-          Specific definitions and criteria for many psychiatric disorders are vague and arbitrary, too much room for opinions and interpretations

-          Common treatments are ultimately far more damaging than helpful to patients

Key criticisms of psychopathology include:

-          Inappropriate use of medical concepts including the miss-categorisation of disorders

-          Systems of diagnosis, DSM are ill founded and stigmatise patients

‘Modern psychiatry has yet to convincingly prove the genetic/biological cause of any single mental illnesses’ – David Kaiser – suggesting that there is no evidence for the cause of any mental illness.

Characteristics of schizophrenia

Prevalence: In most countries around the world, prevalence of schizophrenia is about 1% of the population over 18

Subtypes of schizophrenia:

-          Paranoid – characterised by delusions and hallucinations, symptoms such as disorganised speech and flat affect

-          Catatonic – categorised by unusual motor activity, marked agitation or complete immobility, along with extreme negativism (rare disorder)

-          Disorganised – often begins at an early age, characterised by incoherent and disorganised speech , flat affect and disorganised speech

-          Undifferentiated – shows schizophrenic symptoms that do not fit into another category

-          Residual – One episode of schizophrenia in the past but no longer exhibiting, prominent signs of the disorder

Characteristics

·         Main characteristics: distorted thinking, impaired emotional response, poor interpersonal skills, distortion of reality, delusions and hallucinations

·         Neglogisms – breaks in train of thought resulting in coherence and irrelevant speech

·         Catatonic behaviour – negative symptoms, paucity of speech, blunting or emotional response

Symptoms of schizophrenia

First rank symptoms: These are sufficient on their own for a diagnosis of schizophrenia

Behavioural symptoms: Directly observable symptoms

Positive symptoms: These appear to be added by the disorder

Negative symptoms: Things that are taken away by the disorder

Positive first rank symptoms:

-          Auditory hallucinations: Bizarre, unreal perceptions of the environment that are usually auditory, but may also be visual, tactile and olfactory (smelling)

-          Disordered thinking: Feeling that thoughts have been inserted into or withdrawn from the mind.

Positive behavioural

-          Poor attention focus

-          Loose attention focus

Negative behavioural symptoms

-          Disturbances of affect (emotion):

o   Affective flattening – a reduction in the range and…

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