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    Volume I


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  • › What is Schizophrenia? › History of the Concept of Schizophrenia › DSM-IV-TR Diagnostic Criteria for Schizophrenia › Symptoms of Schizophrenia

    ✓Positive Symptoms of Schizophrenia ✓Negative Symptoms of Schizophrenia

    › Eight categories of symptoms of Schizophrenics › Schizophrenia: Facts at a Glance › WHO Key Facts regarding Schizophrenia

  • What is Schizophrenia?

    Schizophrenia is a psychological disorder characterized by psychotic symptoms that significantly affect emotions, behavior, mental processes and mental contents.

    According to Davison & Neale (1984), “Schizophrenia is a psychotic disorder characterised by major disturbances in thoughts, emotion, and behaviour- disordered thinking in which ideas are not logically related; faulty perception and attention; flat or inappropriate affect; and bizarre disturbances in motor activity. Patients with schizophrenia withdraw from people and reality, often into a fantasy life of delusions and hallucinations.”

  • Schizophrenia is a major psychiatric disorder that can

    have a profound effect on the individual, his or her family

    members, and society at large.

    Schizophrenia is characterized by a combination of

    psychotic symptoms, such as hallucinations and delusions,

    and negative (or deficit) symptoms, such as apathy,

    paranoia, and blunted affect.

    Symptoms of the disease is impaired functioning,

    including the ability to participate in meaningful and

    reciprocal relationships with others, to take care of

    oneself, and to function at work, school, or as a parent.

    What is Schizophrenia?

  • Because of the long-term impact of schizophrenia on

    functioning, and the episodic nature of psychotic symptoms

    that tend to vary in their presence and intensity—at times requiring temporary hospitalization to protect the individual or

    others—most people with schizophrenia rely on family members and disability benefits to meet their basic needs. The loss in

    functional capacity, combined with the intermittent need for

    inpatient psychiatric treatment, makes schizophrenia a costly

    disease to society (Rice, 1999; Samnaliev & Clark, 2008).

    In fact, due to the loss of productivity and premature death

    attributed to schizophrenia, it is considered one of the top 10 of

    all diseases in the world contributing to disability burden (Murray

    & Lopez, 1996).

    What is Schizophrenia?

  • History of the Concept of Schizophrenia

    ❖ The concept of Schizophrenia was initially formulated by two European psychiatrists; Emil Kraepelin and Eugen Bleuler.

    ❖ In 1898, Emil Kraepelin, the German psychiatrist, first presented his notion of DEMENTIA PRAECOX, the early term of Schizophrenia.

    ❖ His term dementia praecox reflected what he believe was the common core- ✓ Praecox- an early onset. ✓ Dementia- deteriorating course marked by a

    progressive intellectual deterioration.

  • History of the Concept of Schizophrenia

    ❖ Eugen Bleuler, the Swiss psychiatrist , contributed to the conceptions of Schizophrenia and coined the term.

    ❖ Bleuler broke with Kraepelin on two major points: ✓ He believed that the disorder did not necessarily

    have an early onset. ✓ He also believed that it does not inevitably

    progress towards dementia.

    ❖ Thus the label dementia praecox was no longer appropriate.

    ❖ In 1908, Bleuler proposed the term, Schizophrenia from the Greek word Schizein meaning “to split” and Phren meaning “mind”.

  • Kurt Schneider, a German psychiatrist, proposed that particular forms of hallucinations and delusions, which he calls First-Rank symptoms, are the central to defining Schizophrenia and it’s diagnosis. ✓ Voices Arguing, ✓ Voices commenting on 1’s action, ✓ Thought withdrawal, ✓ Thought Insertion, ✓ Thought Broadcasting, ✓ Made feelings, ✓ Made Impulses, ✓ Made Volitional acts, ✓ Delusional perception & ✓ Somatic Passivity

  • DSM-IV-TR Diagnostic Criteria for Schizophrenia

    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) disorganized speech

    (4) grossly disorganized or catatonic behavior

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


    Note: Only one Criterion A symptom is required if delusions are

    bizarre or hallucinations consist of a voice keeping up a running

    commentary on the person’s behavior or thoughts or two or more voices conversing with each other.

  • DSM-IV-TR Diagnostic Criteria for Schizophrenia

    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).

    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).

    Source: The Diagnostic and Statistical Manual of Mental Disorders, Text Revision, Fourth Edition,

    (Copyright 2000) American Psychiatric Association.

  • Symptoms of Schizophrenia

    The criteria for schizophrenia in DSM-IV-TR fall into two clusters:

    • Positive symptoms: it comprise excesses or distortions such as delusions, hallucinations , disorganized speech and

    disorganized behavior. These symptoms are of an acute

    episode of Schizophrenia.

    • Negative symptoms: consisting of the absence or reduction of normal mental processes, mental contents, feelings, or

    behaviors, including speech, emotional expressiveness, and/or

    movement. It consist of behavioral deficits, such as avolition,

    alogia, anhedonia, flat affect, and asociality.

  • Positive Symptoms of Schizophrenia

    Positive symptoms are so named because they are

    marked by the presence of abnormal or distorted

    mental processes, mental contents, or behaviors.

    Positive symptoms of schizophrenia are:

    • hallucinations (distortions of perception), • delusions (distortions of thought), • disorganized speech, and • disorganized behavior.

  • Negative Symptoms of Schizophrenia

    In contrast to positive symptoms, negative symptoms

    are marked by the absence or reduction of normal

    mental processes, mental contents, or behaviors.

    DSM-IV-TR specifies three types of negative symptoms:

    • flat affect, • alogia, and • avolition.

    Each of these reflects the lack of a normal mental

    process, expression of feeling, or behavior, but they

    differ in what—specifically—is lacking.

  • Eight categories of symptoms of Schizophrenics

    While at some point in their disorder all Schizophrenics either have some type of thoughts disorder or hallucinations, they typically also show disturbances in several other symptoms categories as well. Eight categories of symptoms are as follows:

    1. Content of Thought: Here the major symptom is some delusion or false belief.

    2. Form of Thought: Formal thought disorder involves abnormalities I the way a person’s thought processes are organised. “Loose association” in which ideas shift from one unrelated topic to another, are a common example of this type of symptom.

  • Eight categories of symptoms of Schizophrenics

    3. Perceptions: Hallucinations or the reporting of experiences for which there appear to be no tangible stimuli are the major symptoms of this category.

    4. Affect: This category involves disturbed emotions. Most common are emotions that are blunted, flat or inappropriate to the situation.

    5. Sense of Self: These symptoms refers to persons’ confusion about their identities; they may feel unreal or uncontrolled by forces outside their control.

  • Eight categories of symptoms of Schizophrenics

    6. Volition: The symptoms involves reduced motivation and interest in pursuing almost any sort of goal. They interfere severely with a person’s ability to work.

    7. Relationship to the external world: Schizophrenics often withdraw from the external world and become preoccupied with internal fantasies and odd ideas. These symptoms are sometimes called “autistic”.

    8. Psychomotor behaviour: Abnormalities

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