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Psychopathology II.docx

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Joe Kim

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Psychopathology II • There are no ‘main symptoms’ of schizophrenia Symptoms of Schizophrenia • There are several broad categories of schizophrenia, these symptoms are either positive, negative, or catatonic behaviour • Positive symptoms- behaviours that increase in someone with schizophrenia • Negative symptoms- behaviours that decrease in someone with schizophrenia • Catatonic behaviours- movement behaviours that an individual exhibits which are not in response to any event in the environment • Patients with schizophrenia may experience only some of these symptoms, and the severity of these symptoms varies Positive Symptoms • There are three: 1. Disorder of thought 2. Delusions 3. Hallucinations Disorders of thought • A schizophrenia individual’s train of thought may consist of ideas that are often loosely related to each other. • There speech may be vague and abstract. • The content of schizophrenic thought may contain bizarre delusions. A delusion is a belief that is irrational, or unsupported by external evidence (i.e. the individual is being persecuted by others • For an example, individuals with schizophrenia may believe that a character on television is speaking to or about them directly • Delusions are usually about thought or thinking itself: 1. Delusion of thought broadcast: the belief that others can hear one’s thoughts 2. Delusion of thought withdrawal: the belief that the individual’s thoughts are being removed from his head before he can think them 3. Delusion of thought insertion: the belief that thoughts are being placed in the individual’s head by others • Positive schizophrenic symptoms are new behaviours that emerge in patient (i.e. hallucinations) • Auditory hallucinations are more common than visual hallucinations • The voice hallucinated are usually saying negative things, commenting on the individual’s behaviour, or giving orders Negative Symptoms • Decrease in the individual’s engagement with the outside world • Individual may become less interested in people and events in the outside world, and more concerned with internal ideas or fantasies • Can lead to an increasing neglect of one’s personal appearance • Individual emotional response may also change • Affect: refers to emotional responsiveness • A person with inappropriate affect shows emotional reactions that are inappropriate to the situation Catotonic Behaviour • Unrelated to stimuli from the outside world • Catatonia can result in a dramatic reduction in movement, sometimes to the point of ceasing to move at all, which is known as catatonic rigidity or catatonic stupor • Catoatonic excitement occurs when there are repeated and stereotyped motor movements that seem to have no purpose at all, and they are unrelated to what is going on around the person Subtypes of Schizophrenia • There are several subtypes of schizophrenia based on patterns of symptoms that dominate the clinical presentation. These subtypes include paranoid • Some cases of schizophrenia do not fit into one of the established subtypes • Undifferentiated schizophrenia is used to categorize cases which do not fit into any of the categories Paranoid Schizophrenia • The dominant symptom is delusions or auditory hallucinations with a single theme • The individual’s thinking may be relatively coherent, with no disturbed affect, or psychomotor disturbance • Often shows anger or anxiety related to the disturbing content of the delusions Catatonic schizophrenia • Dominant symptoms are psychomotor disturbance (catatonic stupor, catatonic excitement) • May include stereotype postures or mannerisms, together with waxy flexibility Disorganized schizophrenia • Most servers and disruptive types of schizophrenia • Thought and speak are incoherent, with very loose associations, and disorganized behavior • Shows flat or inappropriate affect, and any illusions present are incoherent and fragmentary • May be marked psychomotor disturbance and profound social withdrawal Causes of Schizophrenia • Thought to develop when there is genetic predisposition for the disorder and some environmental stress that triggers the symptoms • It is believed that this inherited disposition could be the result of abnormalities in the brain structure or changes in levels of neurotransmitters • Stress and problems with relationships with others can lead to the symptoms of schizophrenia Treatment of Schizophrenia • Pharmacological treatment is one of the most common therapy • Drugs that are effective against the symptoms of schizophrenia can have severely unpleasant side effects • Psychotherapy alone does not help in treating the major symptoms of schizophrenia, but it can help the patient develop new coping strategies one drugs have relieved their symptoms
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