1. Clinical Psychology Unit 4 Describe the features and symptoms of Schizophrenia http://www.youtube.com/watch?v=iasrGrbylIM

2. CLINICAL CHARACTERISTICS OF SCHIZOPHRENIA

3. 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

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

5. 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

6. 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

7. 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

8. Cut and Stick activity http://www.youtube.com/watch?v= KYHVbLLO2bU What might it be like?

9. 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

10. 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

11. 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

12. Schizophrenia onset Source: CIHI (2001)

13. 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

14. Homework / task  Case studies…