Understanding Schizophrenia: Unraveling the Complexities of Psychosis and Its Clinical Manifestations

Schizophrenia - Psychosis - State in which a person loses contact with reality in keyways - Most commonly appears as schizophrenia - Schizophrenia - Psychotic disorder in which personal, social, and occupational functioning deteriorate As a result of unusual perceptions, odd thoughts, disturbed emotions, and motor Abnormalities - 1 of 100 experience schizophrenia during lifetime - 21 million worldwide: 3.6 million in the United States - Equally distributed between men and women - Average age at onset: 23 for men; 28 for women - Significant financial and emotional costs - 25 percent attempt suicide; 5 percent die - Increased risk of physical illness - More frequently found in lower-SES groups - Downward drift theory - Checklist: Schizophrenia - For 1-month, individual displays two or more of the following symptoms much of the The time - Delusions - Hallucinations

- Disorganized speech - Very abnormal motor activity, including catatonia - Negative symptoms - At least one of the individual ’ s symptoms must be delusions, hallucinations, or Disorganized speech - Individual functions much more poorly in various life spheres than was the case prior To the symptoms - Beyond this 1 month of intense symptomology, individual continues to display some Degree of impaired functioning for at least 5 additional months The Clinical Picture of Schizophrenia - Schizophrenia produces many clinical pictures - Positive, negative, and psychomotor symptoms - The symptoms, triggers, and course of schizophrenia vary greatly - Some clinicians have argued that schizophrenia is a group of Distinct disorders that share common features - Positive symptoms - Bizarre additions to a person ’ s behavior - Delusions: Single or many - Delusions of persecution - Delusions of reference - Delusions of grandeur - Delusions of control

- Disorganized thinking and speech - Loose associations or derailment - Neologisms - Perseveration - Clang or rhymes - Inappropriate affect - Situationally unsuitable - May sometimes be an emotional response to other disorder features - Heightened perceptions and hallucinations - Problems of perception and attention - Perceptions in the absence of external stimuli may occur together - Negative symptoms - Pathological deficits - Poverty of speech - Reduction of quantity of speech or speech content - May also say quite a bit but convey little meaning - Restricted affect - Show less emotion than most people - Avoidance of eye content - Immobile, expressionless face - Blunted affect - Flat affect

- Loss of volition - Feeling drained of energy and interest in normal goals - Inability to start or follow through on a course of action - Ambivalence: Conflicted feelings about most things - Psychomotor symptoms - Awkward movements, repeated grimaces, and odd gestures - Movements seem to have a magical quality - Symptoms may take extreme forms, collectively called catatonia - Includes stupor, rigidity, posturing, and excitement - Experienced by about 10 percent of people with schizophrenia - Course of schizophrenia - Schizophrenia usually first appears between the late teens and mid-thirties - Three phases - Prodromal: Beginning of deterioration; mild symptoms - Active: Symptoms become apparent - Residual: Return to prodromal-like levels - Each phase of the disorder may last for days or years - A fuller recovery from the disorder is more likely in people - With good premorbid functioning - Whose disorder was triggered by stress - With abrupt onset - With later onset

- Who receive early treatment - Diagnosing schizophrenia - DSM-5 diagnosis of schizophrenia - Symptoms of the disorder continue for 6 months or more - People have active symptoms for at least one of those months and show A deterioration from previous levels of functioning - Several schizophrenia-like disorders in DSM-5 are called schizophrenia spectrum Disorders - Schizophreniform disorder - Schizoaffective disorder - Many researchers believe that a distinction between type I and type II schizophrenia Helps predict the course of the disorder. - Type I schizophrenia is dominated by positive symptoms - Type II schizophrenia is dominated by negative symptoms How Do Theorists Explain Schizophrenia? - Biological views - Inheritance and brain activity play key roles in development of schizophrenia - Genetic factors have research support - Relatives of people with schizophrenia - Twins with schizophrenia - People with schizophrenia who are adopted - Direct genetic research and molecular biology