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Chapter 14

01:830:340 Chapter 14: Chapter14Schizophrenia

Course Code
Dr.Edward Selby

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Chapter 14: Schizophrenia
The word Schizophrenia comes from the Greek words for “split mind” and it does not mean
multiple personalities.
Patient may experience psychosis which means a loss of contact with reality
Taking LSD or abusing amphetamines or cocaine may produce psychosis
Approximately 1 of every 100 people in the world suffers from the schizophrenia during his or her
An estimated 24 million people worldwide are affected with it, including 2.5 millions in the US.
People with schizophrenia have an increased risk of physical often fatal illness. On average, they
live 20 fewer years than other people.
It is estimated that as many as 25% of people with schizophrenia attempt suicide.
DSM-5 Criteria for Schizophrenia:
A). A core symptoms: two or more of the follwing symptoms present for at least a 1-month period
The Symptoms of Schizophrenia:
Bleuler: Fundamental Symptoms: The 4 “A”s (almost always present)
1. Loose associations: person’s flow of thought is vague, unfocused; the connections aren't there
between the thoughts(pathognomonic)
2. Autistic withdrawal: self-absorbed, withdrawn person; highly idiosyncratic view of the world;
fantasy life
3. Ambivalence: indecisiveness, contradictory feelings about things
4. Affective disturbance: either inappropriate affect (mismatch between behavior and the
emotional tone exhibited) or absent affect (decreases in range of emotional tone)
The symptoms of schizophrenia can be grouped into three categories.
Positive symptoms: excesses of thought, emotion, and behavior
Negative symptoms: deficits of thought, emotion, and behavior
Psychomotor (Cognitive) symptoms: unusual movements or gestures; disorganized
thought content
Positive Symptoms:
Positive symptoms are “pathological excesses” or bizarre additions, to person’s behavior.
Delusions, disorganized thinking and speech, heightened perception and hallucinations, and
inappropriate affect are the ones most often found in schizophrenia
Delusion: a strange false belief firmly held despite evidence to the contrary.
People may consider the ideas enlightening or may feel confused by them.
Some people hold a single delusion or many delusion that dominated their lives.
They believe that they are being plotted or discriminated against, spied on,
slandered, threatened, attacked, or deliberately victimized.

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People with schizophrenia may alse have delusions of reference: they attach
special and personal meaning to the actions of others or to various objects or
People with delusions of grandeur believe themselves to be great inventors,
religious survivors, or other specially empowered persons.
People with delusions of control believe their feelings, thoughts, and actions are
being controlled by other people.
Disorganized thinking and speech: may not be able to think logically and may speak in
peculiar ways
These formal thought disorders can cause the sufferer great confusion and make
communication extremely difficult.
Often such thought disorders take the form of positive symptoms, as in loose
association, neologisms, perseveration and clang.
People who have loose associations, or derailment, the most common formal
thought disorder, rapidly shift from one topic to another, believing that their
incoherent statements make sense. A single, perhaps unimportant word in one
sentence becomes, the focus of the next one.
People with schizophrenia use neologism, made-up words that typically have
meaning only to the person using them.
Others may have the formal thought disorder of perseveration, in which they
repeat their words and statements again and again.
Some people clang or rhyme, to think or express themselves.
Heightened Perceptions and Hallucinations: the persons may feel that their sense are
being flooded by all the sights and sounds that surround them.
Smooth pursuit eye movement - weakness that may be related again to attention
problems. When asked to keep their head still and track a moving object back
and forth with their eyes, research participants with schizophrenia tend to perform
poorly than those without schizophrenia.
Hallucinations , perceptions that a person has in the absence of external stimuli.
People who have auditory hallucinations, by far the most common kind in
schizophrenia, hear sounds and voices that seem to come from outside their
heads. The investigators found more blood flow in Broca’s area while patients
were having auditory hallucinations. A related study revealed increased activity
near the surfaces of their brain, in the tissues of the auditory cortex, the brain’s
hearing center.
Tactile hallucinations may take the form of tingling, burning, or electric-shock
Somatic hallucinations feel as if something is happening inside the body, such as
a snake crawling inside one’s stomach.
Visual hallucinations may produce vague perceptions of colors or clouds or
distinct visions of people or objects.
Gustatory hallucinations smell odors that no one else does, such as the smell of
poison or smoke.
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