Characterisitcs of schizophrenia

• Lifelong illness affecting 1% of population

  Not multiple personality disorder

  Causes a person to break with reality

  Delusions, hallucinations,problems with speech and behaviour, occupational and social dysfunction
• Can be treated, but no known cure

  Will suffer “episodes” of severe symptoms, but can be symptom-free for long periods

  Can increase the risk of violent behaviour, but schizophrenics are not a public risk
• The experience of schizophrenia will differ from person to person

  Different people will present with different combinations of symptoms.
• Schizophrenia is a severe long-term mental health condition. It causes a range of different psychological symptoms.

  Doctors often describe schizophrenia as a type of psychosis. This means the person may not always be able to distinguish their own thoughts and ideas from reality.
• The characteristic symptoms of schizophrenia involve a range of cognitive, behavioural, and emotional dysfunctions, but there is no definitive symptom of the disorder.

  The diagnosis involves the recognition of a cluster of signs and symptoms associated with impaired occupational or social functioning.

  Individuals with the disorder will vary substantially in most features.
• Prodrome: an early symptom indicating the onsetvof a disease or illness.

  In the weeks or months preceding schizophrenia, an individual may show some prodromal symptoms.

  These symptoms are not enough to diagnose schizophrenia, as they also occur in other illnesses.

  It is only in retrospect once full schizophrenia has been diagnosed that these symptoms may be seen as the onset of the disorder.
• Schizophrenia is diagnosed by either a doctor or psychiatrist after someone has presented with symptoms that meet criteria set out in either the ICD-11 (The International Statistical Classification of Diseases and Related Health Problems) or the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders).

  • The ICD-11 is published by the World Health Organisation (WHO).
  • The DSM-5 is published by the American Psychiatric Association (APA).
• In the UK and Europe, the ICD-11 is used to diagnose schizophrenia, along with many other mental illnesses. In the USA, the DSM-5 is used instead.

  Both classification systems are based on the most up-to-date research in psychology and psychiatry and are periodically revised and updated. The ICD is currently on its 10th edition, and the DSM is on the 5th.
• • Positive symptoms – behaviours and thoughts that the person with schizophrenia did not have before they became ill.
• • Negative symptoms – behaviours and thoughts that the person with schizophrenia used to have but have now lost or reduced due to the illness.
• Delusions

  Delusions are beliefs that are not real. These are usually experienced when there is no evidence to support the delusion. There are many possible types, but here are three of the most common ones are delusions of persecution, delusions of grandiosity and delusions of reference
• • Delusions of persecution – A belief that one is going to be harmed by an individual or organization. For example, believing that the MI5 are following you or believing that a family member or friend is plotting against you.
• • Delusions of grandiosity – A belief that one is special in some way or has assumed the identity of a famous person, like Winston Churchill.
• • Delusions of reference – A belief that environmental stimuli, like newspapers and TV adverts, are communicating hidden messages to them. For example, an individual may believe that there are coded messages for them in newspapers.
• Hallucinations - Hallucinations are perceptions that are not real. There are three main types: Auditory, Tactile and Visionary
• • Auditory – Hearing voices or sounds that no one else can hear. Some people with schizophrenia report hearing voices that are friendly and pleasant, but the majority who suffer with auditory hallucinations say that the voices they hear are rude and critical. Research using brain scans have highlighted that there are changes in the speech area of the brains of people with schizophrenia, when they hear voices. This suggests that the brain is mistakenly interpreting the hallucination as a real voice.
• • Tactile – This refers to when a person senses that they are being touched when they are not. An example of this is formication, which is the name for a sensation that resembles small insects, such as spiders crawling on (or under) the skin.
• • Visual – This refers to seeing objects or people that are not there.
• Disorganised speech

  Speech – The sentences of someone suffering from schizophrenia maybe mixed up and difficult to understand. It may seem like their speech is jumping from one topic to another, without any logical flow, which makes it difficult to follow. This is referred to as word salad.

  Word salad example: Typing while sleeping and running while cat.
• Disorganised thinking

  Thinking – Someone suffering with schizophrenia may report having thoughts in their head that are not their own; thoughts that belong to somebody else. This is referred to as insertion.
• Disorganised behaviour - The behaviour of the person suffering with schizophrenia may become disorganised and unpredictable. For example, the person may behave inappropriately or shout/swear for no reason.
• Delusions, hallucinations, disorganised thinking and speech and disorganised behaviour are all examples of positive symptoms
• Negative symptoms

  Symptoms that are associated with a decrease or loss of normal functions
• Negative symptoms can appear several years before an individual experiences their first acute schizophrenic episode
• Prodromal period of schizophrenia

  • Initial negative symptoms that appear gradually and slowly get worse
• Prodromal period symptoms

  • Becoming more socially withdrawn
  • Showing an increasing lack of care about appearance and personal hygiene
• Such symptoms often appear in other mental illnesses, which is why it is sometimes difficult to know whether an individual is suffering from the early onset of schizophrenia
• Avolition - A person suffering with schizophrenia may lose interest and motivation in life and activities. This can include things that they once enjoyed like work, relationships and sex.
• Anhedonia - A person suffering with schizophrenia may develop an inability to feel pleasure. This may result in the person not reacting appropriately to pleasurable experiences. For example, not experiencing joy at their sports team winning.
• Alogia - he total amount of speech produced by someone suffering with schizophrenia will often decrease. The word comes from the Greek words meaning ‘without speech’ and refers to a poverty of speech that results from impairment in thinking that affects language abilities.
• Flat affect - A person suffering with schizophrenia may appear to have diminished emotional expression. They may hold conversations without any indication of emotional tone and show little or no facial expressions.
• Catatonic behaviour - A person suffering from schizophrenia may display varied bodily movements. This could range from a stupor, to fast repetitive movement, to the mimicking of other behaviour around them (echopraxia)