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Chapter 11

PSYB32H3 Chapter Notes - Chapter 11: Deinstitutionalisation, Biopsychosocial Model, Tardive Dyskinesia

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Konstantine Zakzanis

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Chapter 11: Schizophrenia
Schizophrenia: psychotic disorder characterized by major disturbances in through, emotion, and
behaviour disordered thinking in which ideas are not logically related, faulty perceptions and
attention, flat or inappropriate affect, and bizarre disturbances in motor activity
They withdraw from people and reality, often into a fantasy life of delusions and hallucinations
Its own of the most severe psychopathologies
Prevalence of 1%
Clinical Symptoms of Schizophrenia
Disturbances in several major areas thought, perceptions and attention, motor behaviour; affect
or emotions and life functioning
There is a lot of heterogeneity
Positive Symptoms
Positive symptoms: comprise excesses or distortions, such as disorganized speech,
hallucinations and delusions, an acute episode of schizophrenia
It involve the presence of a behaviour that is not apparent in most people
Disorganized speech
Aka formal thought disorder
Disorganized speech: problems in organizing ideas and in speaking so that a listener can
There is incoherence in conversations (not connected and hard to understand)
Speech may also be disordered as loose associations/derailment (difficulty sticking to one
oThey may drift off in what they are saying
But disorganized speech is not a discriminator between schizophrenia and other psychoses (like
some mood disorders)
Thinking that others are plotting against you
Delusions: beliefs held contrary to reality, are common positive symptoms
Persecutory delusions are found in 65% of them
They may think their thoughts are beings stolen from them or are being broadcasted
Hallucinations and Other disorders of Perception
They may feel depersonalized
Hallucinations: sensory experiences in the absence of any stimulation from the environment
(more auditory than visual)
oThey hear their own thoughts spoken by another voice
oThey hear voices arguing
oHere voices commenting on their behaviour
Negative Symptoms
Negative symptoms: behavioural deficits, such as avolition, alogia, anhedonia, flat affect and
They tend to endure beyond an acute episode and have profound effects on the lives of patients
Flat affect can be a side effect of antipsychotic medication
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Apathy/avolition: lack of energy and seeming absence of interest or inability to persist in what
are usually routine activities
Inattentive to grooming and personal hygiene
Difficulty persistent at work, school or household chores
A negative thought disorder
Poverty of speech, sheer amount of speech is greatly reduced
Poverty in content of speech
Vague and repetitive speech
An inability to experience pleasure
They are aware of it
Flat Affect
No stimulus can elicit an emotional response
Stare vacantly, muscles of face flaccid, and eyes lifeless
Flat and toneless voice
impaired social relationships
few friends, poor social skills and little interest being with people
Schizophrenia onset is beginning in childhood
It is also said that they might not be able to recognize the emotions on top of not being able to
express it
Other Symptoms
Catatonia: several motor abnormalities
oGesture repeatedly, using peculiar and complex finger sequences of finger, hand and
arm movements
oSometimes excitement, wild flailing of the limbs
oCatatonic Immobility: patients adopt unusual postures and maintain hem for a very long
period of time (stand on one leg)
oWaxy flexibility: another person can move the patients limb into strange positions that
the patient will then maintain for extended periods
Inappropriate affect: emotional response are out of context (laugh at someone’s death)
othey shift rapidly from one state to another for no discernible reason
History of the Concept of Schizophrenia
Early Descriptions
formulated by Kraepelin and Bleuler
dementia praecox: early term for schizophrenia
he divided it into 2 major groups of endogenous or internally caused psychosis
omanic-depressive illness
odementia praecox
included dementia paranoids, catatonia, and hebephrenia
The DSM-IV-TR Diagnosis
Schizoaffective disorder: comprises a mixture of symptoms of schizophrenia and mood
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