Clinical Psychology Unit 4 Describe the features and symptoms of Schizophrenia

CLINICAL CHARACTERISTICS OF SCHIZOPHRENIA

Learning objectives You must: You should: You could also: 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 NEGATIVE SYMPTOMS – TYPE 2 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 Negative 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

There are more than these but these are the main ones 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 symptoms For 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