COGS101 Lecture Notes - Lecture 10: Executive Functions, Tom Group, Cognitive Model
2 Jun 2018
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Schizophrenia – Week 10
What is schizophrenia?
• Severe psychiatric illness
• Serious mental disorder, affects 1 in 100 people in some point in their lives
• Typically occurs in late adolescence to early adulthood, roughly equal in
males and females
• On average, earlier onset in males than females (small though)
• Varying courses of illness in different people
• More females in 46-55 age group than you see males (reason is menopause;
eostrogen hypothesis – protective eostrogen)
• Low in 75+ ages, but females higher than males
• Symptoms include:
o Psychotic symptoms – breakdowns
o Delusions/false beliefs or perceptions → the most common delusions
are persecutory delusions; trying to harm one another etc.
▪ Delusions of reference → patient develops mistaken beliefs
about what normally would be seen as innocuous, everyday
events in the environment having some special meaning just for
them
▪ Grandiose delusions → great power
▪ Many other delusions; religious, somatic
o Hallucinations
▪ Most often they are auditory verbal (hearing voices)
▪ Also can experience visual hallucinations (seeing things,
colours etc,)
▪ Somatic hallucinations – sensation that they are being stabbed
How is schizophrenia diagnosed?
• Diagnosis of schizophrenia done on the basis of symptoms reported and
observed
• Traditionally schizophrenia is associated with ‘psychotic’ symptoms
• Two characteristics are delusions and hallucinations
• Sometimes disordered speech and communication – often has a similar flavour
of breakdown of reality
• Disorganisation of behaviour
• Schizophrenia is different in that the current criteria for diagnosis (DSM5) is
that you need to seek any 2 or more of characteristic symptoms (delusions,
hallucinations, disorganized speech/behaviour or negative symptoms e.g.
apathy, flat affect, anhedonia)
• At least one of first 3 must be present
• Would expect to see some drop in social and occupational functioning –
common feature in schizophrenic individuals
• At least 6 months with these 2 minimal symptoms must be present in order to
diagnose someone with schizophrenia
• Current understanding
o ‘Negative’ symptoms e.g. apathy as important as
o Positive symptoms
▪ Negative = something missing
find more resources at oneclass.com
find more resources at oneclass.com
▪ Positive = something unusual present
• Characteristic symptoms: Delusions
o Content can be ‘bizarre’ or ‘ordinary’
o Scope can be widespread or narrow
o Common delusional themes
▪ Persecutory
▪ Delusions of reference
▪ Grandiose and religious e.g. believing you are god or richest
man on earth
▪ Delusions of control e.g. believing someone controls you
▪ ‘Loss of boundary’ → mind-reading, thought broadcast
▪ Somatic delusions, other themes e.g. jealousy, guilt
• Characteristic symptoms: Hallucinations
o Occur in any sensory modality
o Sometimes only one of the senses involved; sometimes several
o Not the same as delusions
o Auditory is most common
▪ Non-verbal (bumps, music)
▪ Verbal hallucinations
• Voices commenting
• Voices conversing
o Visual
o Somatic (body)
o Olfactory (smell), gustatory (taste)
• Characteristic symptoms: disorganized speech
o Common forms
▪ Derailment → response starts off on track, keeps derailing off
topic
▪ Tangetiality → response goes off tangents – not offering
specifics
▪ Illogicality → illogical responses (not as common as two
above)
• Characteristic symptoms: negative symptoms
o Flat affect – loss of emotional expressiveness
o Alogia – lack of amount of speech
o Apathy
o Anhedonia – loss of joy and pleasure
o Asociality – withdrawal from interacting with other people
• Remember diagnosis requires any 2 or more characteristic symptoms – but
you nee d to see at least one of delusions, hallucinations or disorganized
speech/behaviour
• Each symptom itself is variable
o Different delusional themes; hallucinations in different sensory
modalities
• Schizophrenia is a heterogeneous condition
o Different symptoms
o Different ages of onset and time-course
find more resources at oneclass.com
find more resources at oneclass.com
