Diagnosis and Classification

Schizophrenia:

  • Mental disorder experienced by about 1% of the world population

  • More common in men, city-dwellers, lower socio-economic groups

  • Can interfere with everyday tasks so that many people with schizophrenia end up homeless or hospitalised


The two major systems for the classification of mental disorder are the World Health Organisation’s Internatioanl Calssification of Disease and the American Psychiatric Association’s Diagnostic and Statistical Manual

The DSM-5 systems one of the so-called postiive symptoms must be present for diagnosis where two or more negative symptoms are sufficient under ICD

Previous ediations of ICD and DSM recognised subtypes of schizophrenia


POSITIVE SYMPTOMS:

Additional experiences beyond those of ordinary existence including hallucinations and delusions

Hallucinations:

  • Unusual sensory experineces, some are related to events in the environment whereas others bear no relationship to what the senses are picking up

  • Voices heard either talking to or commenting on a perios, often criticising them

  • can be experineced in relation to any sense, person may see distorted facial expressions or occasionally people or animals that are not there


Delusions (paranoia):

  • irrational beliefs

  • Common delusions involve being an important historical, political or religious figure

  • Delusiosn commonly involve being persecutred by perhaps the government, or aliens or for having superpowers

  • Another calss of delusions concerns the body - a person may believe they are under external control, delusions can make a person behave in ways that make sense to them but seem bizarre to others


NEGATIVE SYMPTOMS

Involve the loss of usual abilities and experiences, such as speech poverty and avolition

Speech Poverty:

  • Changes in parrterns of speech

  • Emphasis is on a reduction in the amount and quality of speech in Schizophrenia

  • sometimes accompanies by a delay in the person’s verbal responses during conversation

  • Nowadays more emphasis is put on speech disorganisation - speech becomes incoherent or the speaker changes topic mid-sentence


Avolition:

  • Sometimes called ‘apathy’ - described as finding it difficult to begin or keep up with goal-directly activity

  • People with schizophrenia often have sharply reduced motivation to carry out a range of activities

NANCY ANDERSON (1982) - identified three sings of avolution: poor hygeine and grooming, lack of persistence in work or education, lack of energy


SUMMARY:

Positive Symptoms: overt symptoms that should not be present, they indicate that patient has lost touch with reality

  • Hallucinations

  • Delusions

  • Disorganised Behaviour and Speech

Negative Symptoms: symptoms reflect the absence of normal characteristics

  • Apathy

  • Anhedonia

  • Blunted Affect

  • Speech Poverty

Cognitive Symptoms: reflect patient’s abnormal thinking, poor decicion-making skills, poor problem-solving and ability to communicate has strange behaviour

  • Thought disorders

  • Bizarre Behaviour