Clinical Psychology Unit 4

Describe the features and symptoms of

Schizophrenia

http://www.youtube.com/watch?v=iasrGrbylIM

CLINICAL CHARACTERISTICSOF SCHIZOPHRENIA

Learning objectives

You must: Identify two or more clinical characteristics of

schizophrenia Know and explain differences in the prevalence of

this disorder in different populations

You should: Explain the differences between Type 1 and Type 2

You could also: Outline the difficulties when making a diagnosis

WHAT IS SCHIZOPHRENIA?

Schizophrenia is not a multiple personality

It is a psychotic disorder characterized by the loss of contact with reality

It has many different manifestations with a few shared features

formerly referred to as: Lunacy, madness or insanity

http://www.youtube.com/watch?v=bWaFqw8XnpA

CLASSIFICATION

POSITIVE SYMPTOMS – TYPE 1 Distortion of normal function

NEGATIVE SYMPTOMS – TYPE 2 Lack of normal function

Delusions, hallucinations, disorganised speech, under the control of an alien force, disordered thinking

Apathy, no emotion, flat effect, social withdrawal, Alogia

EVALUATION

Positive symptoms Can be affected by cultural differences Tend to have greater weight when diagnosing Hard to measure objectively

Negative symptoms Start before positive ones Sometimes start years before diagnosis Less affected by cultural factors More objectively measured

SUB TYPES

PARANOID Delusions, persecution, hallucinations

CATATONIC Immobile, catatonic stupors Wild, uncontrolled movements

DISORGANISED Giggling, pulling faces, flat effect.

RESIDUAL low level positive symptoms but psychotic symptoms present

UNDIFFERENTIATED Does not fit into any of above

There are more than these but these are

the main ones

Cut and Stick activity

EVALUATION OF SUBTYPES

Lacks precision

People don’t fit neatly into one or other subtype

Categorising people gives little or no indication of: Cause How it might develop Effective treatment

DIAGNOSIS

Requires two or more POSITIVE symptomsFor a period of at least a month

•Can only be done by a psychiatrist •As yet there is no physical way to diagnose•Current research is looking at blood test or eye tracking

Schizophrenia prevalence

1% lifetime risk in general population

Holds true for most geographical areas although rates do vary

Abnormally high in Southern Ireland, Croatia; significantly lower rates in Italy, Spain (Torrey, 2002)

Risk factors include minority ethnicity, urban residence

Schizophrenia onset

Source: CIHI (2001)

PROGNOSIS

‘Rule of the thirds’ (rule of thumb): 1/3 recover more or less completely 1/3 episodic impairment 1/3 chronic decline

With treatment about 60% of patients manage a relatively normal life

Prognosis better in non-industrialised societies