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Schizophrenia: Classification, Symptoms and Diagnosis

Classification of Schizophrenia

  1. Disorganised Schizophrenia:
    • Thought disturbances
    • Absence of expressed emotion
    • Loss of interests in life
    • Not goal directed
  2. Catatonic Schizophrenia:
    • Severe motor abnormalities
    • Unusual gestures of the body
    • Gesture repeatedly
    • Complex movements
    • Movements have meaning to patient
  3. Paranoid Schizophrenia:
    • Delusional symptoms
    • Patient remains emotionally responsive
    • More alert and verbal
  4. Undifferentiated Schizophrenia
    • Shows signs of schizophrenia, but doesn’t fit into the above categories

Symptoms

Positive:

  • An addition of something
  • Rare in normal everyday experiences

Negative:

  • Something taken away
  • Less dramatic

Secondary:

  • Consequence of the disorder

Positive Symptoms:

  1. Hallucinations:
    • Hearing voices
    • Can hear own thinking
    • Thoughts are loud, others might hear – Thought Broadcasting.
  2. Delusions:
    • Unusual belief, without any supporting evidence
    • Believe that other are trying to harm them
    • Special meanings in ordinary events
    • Grandiose Delusions – exaggerated sense of power, knowledge and identity.
  1. Thought Disturbances
    • Confused
    • Jump between topics
    • Lack of concentration
    • Can’t remember their thoughts

Negative Symptoms

  • Lack of energy
  • Less dramatic
  • Loss of interest in life
  • May stop showing emotion, appear lifeless
  • Speak in flat toneless voice – flat effect
  • Tend to last longer than positive symptoms

Secondary Symptoms

  • Consequences of having the disorder
  • Break down of relationships
  • Loss of employment
  • Depression

Diagnosis

  • STIRLGING AND HELLEWELL – One or more positive symptom must be present for diagnosis
  • OR – two or negative symptoms could lead to diagnosis
  • Must have been apparent for one month
  • Effects men and women equally
  • Cant be admitted against will
  1. Prodomal Phase: individual becomes withdrawn and loses interest in work, and school and leisure
  2. Active Phase: more obvious positive symptoms begin to occur. Duration varies
  3. Residual Phase: the obvious symptoms begin to disappear

Evaluation

Hearing voices not necessarily indicative of psychotic illness – Surveyed 15,000 non-schizophrenics, 10-15% experiences voices, often after loss.

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