Classification

• Schizophrenia - a severe mental psychotic disorder characterised by a profound disruption of cognition and emotion
• Classification

  TO diagnose schizophrenia, psychiatrists use classification systems. This is the process of organising symptoms into categories based on which symptoms cluster together in suffers
• Two classification systems for SZ

  • ICD 10 (published by world health organisation)
  • DSM-V (published by the American Psychiatrist Association)
• DSM-V - Criterion A Characteristic symptoms:

  2 or more of these symptoms, each present for a significant proportion of time in a one month period:

  • Hallucitations
  • Delusions
  • Disorganised speech
  • Grossly disorganised behaviour
  • Negative symptoms

  1 or 2 of the symptoms should be delusions, hallucinations or disorganised speech
• DSM-V - Criterion B Social/Occupational Dsyfunction

  For a significant proportion of time since the onset, one or more major areas of functioning such as work or self care are affected
• DSM-V Criterion C Duration

  Continuous signs of disturbance must persist for at least 6 months.

  This 6 month period must include 1 month of symptoms that meet criterion A
• Positive symptoms - are additions to normal behaviour
• Positive symptoms:

  • Hallucinations
  • Delusions
  • Disorganised speech Grossly
  • Grossly disorganised or catatonic behaviour
• Hallucinations - sensory experiences that have either no basis in reality or are distorted perceptions of things that are there.

  Can be auditory (hearing voices) and visual (seeing things) or tactile (feeling bugs crawling under skin e.g)
• Delusions - bizarre/irrational beliefs that seem real to the person with SZ but are not real.
• Delusions can be:

  • Paranoid - such as belief of being spied on or followed by the government
  • Grandiose - such as belief of being very important or famous
  • Delusions of reference - belief that events in the environment are directly related to themselves
• Disorganised speech - the result of abnormal thought processes, the individual has problems organising their thoughts and this shows up in their speech.

  May slip from one topic to another (derailment) mid sentence. Can also be gibberish - word salad
• Grossly disorganised behaviour- the inability or motivation to initiate a task or to complete it once it is started which leads to difficulties in daily living and can result in decreased interest in personal hygiene.

  Individual may dress strange to other people like wearing heavy clothes on a summers day.
• Catatonic behaviour - characaterised by a reduced reaction to the immediate environment, rigid postures or aimless motor activities
• Negative symptoms - behaviours that are noticeable by their absence compared to normal. Absence of behaviour
• Negative symptoms:

  • Speech poverty
  • Avolition
  • Lack of emotion/mood flattening
• Speech poverty - reduced fluency and complexity of speech

  Patients may say fewer words on a verbal fluency tasks and may include less complex syntax such as shorter utterances, fewer clauses.
• Avolition (lack of motivation) - a reduction in interest and desires which leads to an inability to do things such as sitting in the house for hours everyday and doing nothing

  Signs of avolition include poor hygiene, lack of persistence in work and lack of energy