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PSYB32H3 (1,174)
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Department
Psychology
Course
PSYB32H3
Professor
Konstantine Zakzanis
Semester
Fall

Description
Chapter 11Schizophreniaschizophreniaa group of psychotic disorders characterized by major disturbances in thought emotion and behavior disordered thinking in which ideas are not logically related faulty perception and attention bizarre disturbances in motor activity flat or inappropriate emotions and reduced tolerance for stress in interpersonal relations the patient withdraws from people and reality often into a fantasy life of delusions and hallucinations estimates in the prevalence in the population vary between 022 in part dependent upon the measurement instrument however its lifetime prevalence is about 1 the incidence is significantly higher in males than in females malefemale ratio14 although schizophrenia sometimes begins in childhood it usually appears in late adolescence or early adulthood somewhat earlier for men than for women people with schizophrenia typically have a number of acute episodes of their symptoms between episodes they often have less severe but still very debilitating symptoms most people with schizophrenia are treated in the community however hospitalization is sometimes necessary in Canada hospitalization rates are typically much higher among young men relative to young women about 10 of people with schizophrenia commit suicide 50 of people with schizophrenia have comorbid disordersSchizophrenia and Comorbidity comorbid conditions appear to play a role in the development severity and course of schizophrenia comorbid substance abuse is a major problem for patients with schizophrenia occurring in as many as 70 of them research suggests that childhood conduct disorder problems are potent risk factors for substance use disorders in schizophrenia theres comorbidity between schizophrenia and depression comorbid anxiety disorders are also common and can impose an additional burden on people with schizophrenia and result in further decline in their perceived quality of life comorbidity with OCD is also related to a previous history of suicidal ideation and suicide attempts PTSD is highly prevalent and underdiagnosed among military veterans with schizophreniaClinical Symptoms of Schizophreniathe symptoms of patients with schizophrenia involve disturbances in several major areas thought perception and attention motor behavior affect or emotion and life functioning no essential symptom must be present for a diagnosis of schizophreniaPositive Symptomspositive symptomsin schizophrenia behavioral excess such as hallucinations and bizarre behaviorpositive symptoms comprise excess or distortions such as disorganized speech hallucinations and delusions positive symptoms define an acute episode of schizophrenia positive symptoms are the presence of too much of a behavior that is not apparent in most people while the negative symptoms are the absence of a behavior that should be evident in most peopleDisorganized Speechdisorganized speech thought disorderspeech found in schizophrenics that is marked by problems in organization of ideas and in speaking so that others can understandthis refers to problems in organizing ideas and speaking so that a listener can understand incoherencein schizophrenia an aspect of thought disorder wherein verbal expression is marked by disconnectedness fragmented thoughts and jumbled phrases people with schizophrenia although they may make repeated references to central ideas or a theme the images and fragments of thought are not connected its difficult to understand exactly what the patient is trying to tell the interviewerloose associations derailmentin schizophrenia an aspect of thought disorder wherein the patient has difficulty sticking to one topic and drifts off on a train of associations evoked by an idea from the past with loose associations derailment the patient may be more successful in communicating with a listener but has difficulty sticking to one topic evidence indicates that the speech of many patients with schizophrenia is not disorganized and that the presence of disorganized speech doesnt discriminate well between schizophrenia and other psychoses such as some mood disordersDelusionsdelusionsbeliefs contrary to reality firmly held in spite of evidence to the contrary common in paranoid disorders delusions which are common beliefs contrary to reality are common positive symptoms of schizophrenia please see page 327328 for examples of delusions although delusions are found among more than half of people with schizophrenia as with speech disorganization theyre also found among patients with other diagnosesnotably mania and delusional depression the delusions of patients with schizophrenia are often more bizarre than those of patients in other diagnostic categories their delusions are highly implausible Hallucinations and Other Disorders of Perception patients with schizophrenia often report that the world seems somehow different or even unreal to themhallucinationsperceptions in any sensory modality without relevant and adequate external stimuli the most dramatic distortions of perception are hallucinations sensory experiences in the absence of any stimulation from the environment theyre more often auditory than visual some hallucinations are thought to be particularly important diagnostically because they occur more often in patients with schizophrenia than in other psychotic patients these types of hallucinations includesome patients of schizophrenia report hearing their own thoughts spoken by another voicesome patients claim that they hear voices arguingsome patients hear voices commenting on their behavior Negative Symptomsnegative symptomsbehavioral deficits in schizophrenia such as flat affect and apathy the negative symptoms of schizophrenia consist of behavioral deficits such as avolition alogia anhedonia flat affect and asociality
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