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Lecture 8

Lecture 8: Schizophrenia.docx

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University of Toronto Scarborough
Konstantine Zakzanis

Lecture 8 Schizophrenia - 1% of population will suffer - Psychotic disorder characterized by major disturbances in thought, emotion, & behavior - Disorders thinking in which ideas are not logically related, faulty perception & attention, flat or inappropriate affect, & bizarre disturbances in motor activity Stats - More common in men - Predictors of Outcomes o If within first 3 months of onset of diagnosis the symptoms go away – typically better chance at a good outcome o With each acute episode – falling farther away from pre- functional onset o Poor outcome & poor disability – cognitive impairment - 50% of patients typically have a comorbid disorder - Many smoke to ‘calm’ anxiety Clinical Symptoms of Schizophrenia - Positive Symptoms (psychotic symptoms) o Too much of a behavior that is not apparent in most people o Acute period o Excesses or distortions o Disorganized speech (thought disorder)  Incoherence  Loose Associations  Problems in organizing ideas  Speaking so a listener can understand  Miologisms  Made up words Lecture 8  Echo Lalia  Repeating of what is said to them o Delusions  Characterized by beliefs that are held contrary to reality  Most common – persecutory delusions (something after them, something bad is going to happen to them)  Thought Broadcasting  Watching TV – Newscaster stealing their thoughts & stating them on television set  May believe they are being controlled by external forces o Hallucinations  Sensory experiences from any senses in the absence of any stimulation from the environment  Most common is auditory - Negative Symptoms o Residual stages o Parts of cognition/personality that we should have, but we don’t o Behavioral deficits o Avolition  Lack of energy  Absence of interest/Inability to persist routine activities  Dressing/cleaning – will not finish task o Alogia  Poverty of speech  Lack of speech content  Lacking in amount of speech o Anehdonia  Inability to experience pleasure  However, experimental studies show that patients may have a flat affect – internally, can experience pleasure o Flat Affect Lecture 8 o Asociality  Patients lose social skills  May become impaired in having social relationships  May stem from fact they are paranoid - Other Symptoms o Catatonia  Catatonic immobility  Waxy flexibility  However, rare due to modern medication o Inappropriate Affect  Inappropriate behavior  Highly specific to schizophrenia Diagnosis - Disturbances have to be present for at least 6 months - Must include one month of active phase, which is defined by the presence of at least two of the following: - Delusions, hallucination, disorganized speech, grossly disorganized or catatonic behavior and negative symptoms (only one of these symptoms is required if the delusions are bizarre or if the hallucinations consist of voices commenting or arguing). The remaining time required within the minimum six months can be either a prodromal (Before the active phase) or a residual (after the active phase) period. Problems during the prodromal and residual phases include social withdrawal, impaired role functioning, blun
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