Chapter 11: Schizophrenia
Schizophrenia: a psychotic disorder characterized by major disturbances in
thought, emotion, and behavior.
Prevalence: 0.2% - 2%; lifetime prevalence is generally accepted to be 1%
It is underestimated because some people do not admit to have schizophrenia,
and the population does not include homeless, hospitalized or supervised residential
Can be cultural variant
More males than females (1.4 times more)
Onset: late adolescence or early adulthood; earlier in men than women
Acute episodes of the symptoms
“Early treatment adaptations in case of early non-remission are mandatory”
Schizophrenia and Comorbidity
Comorbid personality disorders are common and have implications for the
course and clinical management of schizophrenia
Substance abuse is a major problem for people with schizophrenia; 37% of
the people with schizophrenia comorbid with substance abuses.
Prodromal phase of schizophrenia: wide variety of comorbid psychiatric
syndromes, esp MDD and cannabis dependence.
11.1 Clinical Symptoms of Schizophrenia
Several important factors: thought, perception, attention, motor behavior,
emotion, life functioning, and duration of the symptoms
Key to understand schizophrenia: recognizing its heterogeneity at the empirical
and conceptual levels
Positive Symptoms: comprise excesses or distortions, such as disorganized
speech, hallucinations and delusions. It is the presence of too much of a
Also known as thought disorder, disorganized speech
Incoherence: the images and fragments of thought are not
Loose associations or derailment: The person has difficulty to stick
to one topic.
However, the patients with mood disorder in manic episode can
have the problems with disorganized speeches, too. (misdiagnose with