Week 6

Schizophrenia

A psychotic disorder lasting at least six months with symptoms like delusions, hallucinations, and disorganized behavior.

Schizotypal (Personality) Disorder

A disorder characterised by social deficits and cognitive distortions beginning before early adulthood.

Schizophreniform Disorder

A condition similar to schizophrenia but with a duration of one to six months.

Schizoaffective Disorder

A disorder featuring symptoms of schizophrenia and a major mood episode, with delusions or hallucinations present for at least two weeks without mood disturbance.

Delusional Disorder

A psychotic disorder defined by the presence of delusions lasting at least one month.

Brief Psychotic Disorder

A short-term psychotic disturbance lasting more than one day but less than a month, with a return to normal functioning.

Psychotic Disorder due to another medical condition

Hallucinations or delusions resulting from a medical condition.

Substance/Medical-Induced Psychotic Disorder

Psychotic symptoms occurring during or after substance use or withdrawal.

Other specified schizophrenia spectrum and other psychotic disorder

Psychotic symptoms causing distress but not meeting full criteria for other disorders, with specified reasons.

Unspecified schizophrenia spectrum and other psychotic disorder

Similar to the previous term but without specified reasons for not meeting criteria.

Emil Kraepelin

Psychiatrist who coined the term "dementia praecox," encompassing various psychotic symptoms.

Eugen Bleuler

Introduced the term "schizophrenia."

Kurt Schneider

Identified "first rank" symptoms of schizophrenia, which are key symptoms of the disorder.

Positive Symptoms

Symptoms of schizophrenia that include delusions, hallucinations, and passivity phenomena.

Negative Symptoms

Symptoms characterised by a lack of emotional expression, motivation, and social engagement.

Disorganisation Symptoms

Symptoms involving disorganised thinking and speech patterns.

Catatonic Symptoms

Motor disturbances including echopraxia, posturing, and waxy flexibility.

Auditory Hallucinations

Hearing sounds or voices without external stimuli, most common hallucination in schizophrenia.

Visual Hallucinations

Seeing things that are not present, less common in schizophrenia.

Olfactory Hallucinations

Smelling non-existent odors, often unpleasant.

Tactile Hallucinations

Sensations of touch or movement on the skin without external stimuli.

Formication

Formica = ant, the sensation of bugs crawling along the skin.

Gustatory Hallucinations

Perception of taste without a stimulus, often unpleasant.

Hypnagogic Hallucinations

Hallucinations occurring while falling asleep.

Hypnopompic Hallucinations

Hallucinations occurring while waking up.

Paranoid Delusion

A false belief of being persecuted or harmed by others.

Persecutory Delusion

Extreme paranoia where benign actions are interpreted as threats.

Delusion of Reference

Belief that common environmental elements have special significance to the individual.

Grandiose Delusion

False belief in exceptional abilities or importance.

Delusion of Influence

Belief that one's thoughts or actions are controlled by external forces.

Nihilistic Delusion

Belief that oneself or the world has no meaning or value.

Bizarre Delusions

Implausible beliefs not grounded in reality.

Capgras’ Syndrome

Belief that a familiar person has been replaced by an impostor.

Delusions of Infidelity

False belief that a partner is unfaithful.

Delusions of Thought Possession

Beliefs regarding external control over one's thoughts.

Thought Insertion

Belief that foreign thoughts are placed in one's mind.

Thought Withdrawal

Belief that one's thoughts are being taken away.

Thought Broadcasting

Belief that one's thoughts can be heard by others.

Thought Blocking

Sudden interruption in thought or speech.

Diagnosis of Schizophrenia

Requires characteristic symptoms, social dysfunction, and a duration of at least six months.

Relationship of Positive Symptoms

Delusions are often congruent with the hallucinations the patient is experiencing.

Diagnostic Criteria for Schizophrenia

Includes numerous criteria that an individual must meet to be diagnosed with schizophrenia.

Criterion A

Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):

1. Delusions.

2. Hallucinations.

3. Disorganised speech (e.g., frequent derailment or incoherence).

4. Grossly disorganised or catatonic behaviour.

5. Negative symptoms (i.e., affective flattening, alogia, or avolition).

Note: only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping a running commentary on the other person’s behaviour or thoughts, or two or more voices conversing with each other.

Criterion B

Social/occupational dysfunction: for a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).

Criterion C

Duration: continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).

Subtypes of Schizophrenia

Includes paranoid, disorganised, catatonic, undifferentiated, and residual types.

Paranoid Schizophrenia

• Preoccupation with delusions and hallucinations.

• Later onset, and better prognosis.

Disorganised Schizophrenia

Disorganised speech, behaviour and inappropriate or flat affect.

Catatonic Schizophrenia

Motor and volition disturbance.

Undifferentiated Schizophrenia

The individual exhibits the characteristic symptoms of schizophrenia but the overall picture is not one of catatonic type, paranoid type, or disorganised type schizophrenia.

Residual Schizophrenia

An individual has suffered an episode of schizophrenia but there are no longer any delusions, hallucinations, disorganised speech or behaviour.

Prevalence of Schizophrenia

Point-prevalence ranges from 0.5% to 1.5%, influenced by various factors.

Age of Onset

Median onset in mid-20s for males and late-20s for females.

Course of Schizophrenia

Onset can be abrupt or insidious, with common prodromal symptoms.

Genetics and Schizophrenia

Genetic factors contribute to the risk of developing schizophrenia.

Dopamine Pathways

Involvement of mesolimbic and mesocortical pathways in the symptoms of schizophrenia.