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Chapter 11

Chapter 11 PSYB32.docx

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University of Toronto Scarborough
Konstantine Zakzanis

Chapter 11  Schizophrenia: psychotic disorder characterized by major disturbances in thought, emotion, and behaviour. People with schizophrenia withdraw from social contact and reality and often have a fantasy life of delusion and hallucinations -> comorbidity is 50% (avoidant, paranoid, dependent, antisocial etc) -> comorbid substance abuse is a major problem for people with schizophrenia -> 10% of schizophrenia suicides  Positive Clinical Symptoms of Schizophrenia -> positive symptoms aren’t “good” but an excess of behaviour whereas negative symptoms is an absence 1. Disorganized Speech: aka thought disorder; refers to the problem in organizing ideas and speaking in a way that people can understand Incoherence: makes no sense, can’t communicate with listener Loose associations: can communicate but has trouble sticking to one topic 2. Delusions: beliefs held contrary to reality. -> Delusions of those with Schizophrenia are usually more bizarre -> ie. Beliefs that others control you or know what you are thinking 3. Hallucinations/other perception disorders: see the world differently or unreal. Depersonalization. Hallucination is a sensory experience in absence of any stimulation in environment, more often auditory than visual.  Negative Behaviour Symptom of Schizophrenia -> many negative symptoms means poor quality of life 1. Avolition: aka apathy, lack of energy and interest in routine activities. Spend much of time doing nothing may forget about hygiene. 2. Alogia: negative thought disorder -> poverty of speech form: amount of speech is greatly reduced. -> poverty of context of speech form: amount of speech is OK but conveys almost no information and is vague/repetitive. 3. Anhedonia: inability to experience pleasure 4. Flat Affect: virtually no stimulus can elicit emotional response, self-reported feelings were OK but you don’t see any movement in facial features or tone. 5. Asociality: few friends poor social skills and little interest in being with other people.  Other symptoms -> Catatonia: several motor abnormalities, ie. Gesture repeatedly, random movements. Could also be overall increase in level of activity (wild flailing limbs, excitement kind of like mania) -> Catatonia immobility: random poses they seem to hold for long periods of time (ie stand on one leg) Inappropriate affect: Their responses to things are inappropriate or out of context, ie may laugh when hear mother died. Shifts emotional state rapidly. E  Early Descriptions of Schizophrenia -> Formed by two psychiatrists Kraepelin and Bleuler. -> Kraepelin notion of Dementia Praecox: early term for schizophrenia. -> Unlike Kraepelin, Bleuler believed the disorder did not have to have an early onset and it did not lead to deterioration of brain and used his own term Schizophrenia for it.  Schizophrenia Diagnosis -> 6 months of disturbance for the diagnosis which must have minimum one month active phase defined by presence of at least 2 of following (delusion, hallucination, disorganize speech, catatonic behaviour, and negative symptoms) however only one needed if they hear voices commenting or arguing. The other time can be prodromal (before active phase) or residual (after active phase). -> Holds cross culturally, however people in developing countries have an easier time recovering and lesser symptoms.  Delusional disorder: troubled by persistent persecutory delusions or jealousy about a wife being unfaithful, organ failure, etc. even though its delusional.  Three subtypes of Schizophrenia 1. Disorganized Schizophrenia: speech is dis
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