PSYC1030 Lecture Notes - Lecture 4: Catatonia, Paranoid Schizophrenia, Alogia
Lecture 4 – 14th August
Part A
SCHIZOPHRENIA
Prevalence
• Approx. 1% of the population suffers from schizophrenia (0.3% - 0.7%)
• Peak age of onset is between 15 & 35 years
• 5% - 6% of people with schizophrenia commit suicide
• Occurs in all cultures and SES groups
• The most expensive of all mental disorders
o Direct treatment costs
o Loss of productivity
o Public assistance costs
Schizophrenia Diagnostic Criteria
A. Characteristic Symptoms: Two (or more) of the following, each present for a significant portion of
time during a 1-month period:
1. Delusions
2. Hallucinations
3. Disorganised speech
4. Grossly disorganised or catatonic behaviour
5. Negative symptoms (affect flattening, alogia, avolition)
Characteristic Symptoms of Schizophrenia:
DELUSIONS
• Disturbances in Content of Thought
• False elief, ased o iorret iferee aout eteral realit, ot osistet ith perso’s
intelligence and cultural background, that cannot be corrected by reasoning.
o Examples:
▪ Delusions of Persecution
▪ Delusion of Grandeur
DISORGANISED SPEECH
• Disturbances in Form of Thought
• Disturbances in production & organisation of thought - revealed by peculiarities of verbal
expression:
o Loosening of Associations
▪ Neologism
▪ Word salad
▪ Tangentiality
HALUCINATIONS
• Disturbances of Perception
• False sensory perception not associated with external stimuli:
o Auditory
o Visual
o Olfactory
o Gustatory
o Tactile
DISORGANISED or CATATONIC BEHAVIOUR
Disturbances in Psychomotor Behaviour
• Catatonia - motor immobility (e.g. rigidity) or marked excitement and overactivity
• Grossly Disorganised Behaviour - excessive and purposeless motor activity
NEGATIVE SYMPTOMS
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Negative Symptoms refer to the absence of normal behaviours or normal functioning and are
characterised by behavioural deficits
➢ Affect flattening
o Affect - the expression of emotion as observed by others (depth of emotion &
feeling tone)
o Limited or severely restricted expression of emotion
➢ Alogia
o Impoverished thinking
o Poverty of speech
➢ Avolition
o Lack of motivation
o Apathy and social withdrawal
Characteristic Symptoms of Schizophrenia
Positive Symptoms (psychotic symptoms) :
➢ Delusions
➢ Hallucinations
➢ Disorganised speech
➢ Disorganised behaviour
THE SCHIZOPHRENIC DISORDERS
• Disorganised type - disorganised speech or behaviour and flat or inappropriate affect
• Catatonic type - marked psychomotor disturbance
• Paranoid type - preoccupation with one or more delusions or frequent auditory
hallucinations related to a single theme
COURSE OF SCHIZOPHRENIA
Prodromal phase – key feature is social withdrawal and is generally associated with deterioration in
role functioning
• Active phase -
• Residual phase
= The active and residual phases of schizophrenia represent the periods commonly
associated with the mental disorder by others viewing the person. The active phase, also
called the acute phase, is characterized by hallucinations, paranoid delusions, and extremely
disorganized speech and behaviours.
Typically the disorder is episodic
AETIOLOGY: Biological Factors
Genetics
• Concordance rate for identical twins is 48%, whereas for non-identical twins it is 17%
• Adoption studies also support inheritance
Abnormal Brain Structures
• Enlarged Ventricles especially on left side
Biochemical Abnormalities
• Dopamine Hypothesis
Viral Infections
• People with schizophrenia are more likely than others to have been born during the winter
when viral infections are more prominent
Pregnancy and Birth Complications
• People with schizophrenia are more likely than the general population to have been exposed
to various proles durig their other’s prega ad to hae suffered irth ijuries.
AETIOLOGY: Social Factors
Social Class
• Schizophrenia is more common in lower SES groups
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Schizophrenia diagnostic criteria: characteristic symptoms: two (or more) of the following, each present for a significant portion of time during a 1-month period, delusions, hallucinations, disorganised speech, grossly disorganised or catatonic behaviour, negative symptoms (affect flattening, alogia, avolition) Delusions: disturbances in content of thought, false (cid:271)elief, (cid:271)ased o(cid:374) i(cid:374)(cid:272)orre(cid:272)t i(cid:374)fere(cid:374)(cid:272)e a(cid:271)out e(cid:454)ter(cid:374)al realit(cid:455), (cid:374)ot (cid:272)o(cid:374)siste(cid:374)t (cid:449)ith perso(cid:374)"s intelligence and cultural background, that cannot be corrected by reasoning, examples, delusions of persecution, delusion of grandeur. Disorganised speech: disturbances in form of thought, disturbances in production & organisation of thought - revealed by peculiarities of verbal expression, loosening of associations, neologism, word salad, tangentiality. Halucinations: disturbances of perception, false sensory perception not associated with external stimuli, auditory, visual, olfactory, gustatory, tactile. Disturbances in psychomotor behaviour: catatonia - motor immobility (e. g. rigidity) or marked excitement and overactivity, grossly disorganised behaviour - excessive and purposeless motor activity.
