Schizophrenia (pronounced /ˌskɪtsɵˈfrɛniə/ or /ˌskɪtsɵˈfriːniə/) is a mental disorder

characterized by a disintegration of thought processes and of emotional

responsiveness. It most commonly manifests as auditory hallucinations, paranoid or
bizarre delusions, or disorganized speech and thinking, and it is accompanied by
significant social or occupational dysfunction. The onset of symptoms typically occurs in
young adulthood, with a global lifetime prevalence of about 0.3–0.7%. Diagnosis is
based on observed behavior and the patient's reported experiences.

Genetics, early environment, neurobiology, and psychological and social processes

appear to be important contributory factors; some recreational and prescription drugs
appear to cause or worsen symptoms. Current research is focused on the role of
neurobiology, but this inquiry has not isolated a single organic cause. The many
possible combinations of symptoms have triggered debate about whether the diagnosis
represents a single disorder or a number of discrete syndromes. Despite the etymology
of the term from the Greek roots skhizein (σχίζειν, "to split") and phrēn, phren- (φρήν,
φρεν-; "mind"), schizophrenia does not imply a "split mind" and it is not the same as
dissociative identity disorder—also known as "multiple personality disorder" or "split
personality"—a condition with which it is often confused in public perception.

The mainstay of treatment is antipsychotic medication, which primarily works by

suppressing dopamine activity. Psychotherapy and vocational and social rehabilitation
are also important. In more serious cases—where there is risk to self and others—
involuntary hospitalization may be necessary, although hospital stays are now shorter
and less frequent than they were.[4]

The disorder is thought mainly to affect cognition, but it also usually contributes to
chronic problems with behavior and emotion. People with schizophrenia are likely to
have additional (comorbid) conditions, including major depression and anxiety
disorders; the lifetime occurrence of substance abuse is almost 50%. Social problems,
such as long-term unemployment, poverty and homelessness, are common. The
average life expectancy of people with the disorder is 12 to 15 years less than those
without, the result of increased physical health problems and a higher suicide rate
(about 5%).

Emil Kraepelin – in 1800’s he described the course of the disorder as a “Dementia

Praecox”.

Eugen Bleuler – in 1900’s he renamed the disorder “schizophrenia” meaning “split

minds” and began to determine that there are different types of schizophrenias.

Kurt Schneider – differentiated behaviors associated with schizophrenia as:

 “first rank” - ( psychotic delusions, hallucinations )

 “second rank” - ( all other experiences and behaviors associated with the
disorder)
Natural progression of schizophrenia is deteriorating in time, with an eventual plateau in the
symptoms. Only for elderly patients with schizophrenia has it been suggested that improvement
MIGHT occur. In reality, no one really knows what the course of schizophrenia would be if
patients were able to adhere to a treatment regimen throughout their lives.

Disorganized Thinking:

1. Echolalia – repetition of another’s words that is parrot-like or inappropriate.

2. Circumstantiality – extremely detailed and lengthy discourse about the topic.
3. Loose Association – absence of normal connectedness of thoughts, ideas, and topics;
sudden shifts without apparent relationship to preceeding topics.
4. Tangentiality – the topic of conversation is changed to an entirely different topic that is
logical progression but causes a permanent detour from the original focus.
5. Flight of ideas – the topic conversation changes repeatedly and rapidly, generally after
just one sentence or phrase.
6. Word Salad – string of words that are not connected in any way.
7. Neologism – words that are made up that have no common meaning and are not
recognized.
8. Paranoia – suspiciousness and guardedness that are unrealistic and often accompanied
by grandiosity.
9. Referential Thinking – belief that neutral stimuli have special meaning to the individual,
such as the television commentator speaking directly to the individual.
10. Autistic Thinking – restricts thinking to the literal and immediate so that the individual has
private rules of logic and reasoning that make no sense to anyone else.
11. Concrete Thinking – lack of abstraction in thinking; inability to understand punch lines,
metaphors, and analogies.
12. Verbigeration – purposeless repetition of words or phrases.
13. Metonymic Speech – use of words interchangeably with similar meanings.
14. Clang Association – repetition of words or phrases that are similar in sound but in no
other way, for example, right, light, sight, might.
15. Stilted Language – overly and inappropriately artificial formal language.
16. Pressured Speech – speaking as if the words are being forced out.

Disorganized Behavior:

1. Aggression – behaviors or attitude that reflects rage, hostility, and the potential for
physical or verbal destructiveness (usually comes about if the person believes someone
is going to do him or her harm.)
2. Agitation – inability to sit still or attend to others, accompanied by heightened emotions
and tension.
3. Catatonic Excitement – a hyperactivity characterized by purposely activity and abnormal
movements such as grimacing and posturing.
4. Echopraxia – involuntary imitation of another person’s movement and gestures.
5. Regressed Behavior – bahaving in a manner of a less mature life stage; childlike and
immature.
 6. Stereotypy – repetitive, purposeless movements that are idiosyncratic to the individual
and to some degree outside of the individuals control.
7. Hypervigilance – sustained attention to external stimuli as if expecting something
important or frightening to happen.
8. Waxy Flexibility – posture held in odd or unusual fixed position for extended periods of
time.

A Somatoform disorder, is a mental disorder characterized by physical symptoms

that suggest physical illness or injury - symptoms that cannot be explained fully by a
general medical condition, direct effect of a substance, or attributable to another mental
disorder (i.e. panic disorder). The symptoms that result from a somatoform disorder are
due to mental factors. In people who have a somatoform disorder, medical test results
are either normal or do not explain the person's symptoms. Patients with this disorder
often become worried about their health because the doctors are unable to find a cause
for their health problems. Symptoms are sometimes similar to those of other illnesses
and may last for several years.

Somatoform disorders are not the result of conscious malingering (fabricating or

exaggerating symptoms for secondary motives) or factitious disorders (deliberately
producing, feigning, or exaggerating symptoms) - sufferers perceive their plight is real.
Additionally, a somatoform disorder should not be confused with the more specific
diagnosis of a somatization disorder.

Recognized somatoform disorders

The somatoform disorders are actually a group of disorders, all of which fit the definition
of physical symptoms that mimic physical disease or injury for which there is no
identifiable physical cause. They are recognized by the Diagnostic and Statistical
Manual of Mental Disorders of the American Psychiatric Association as the following:[1]

 Conversion disorder
 Somatization disorder
 Hypochondriasis
 Body dysmorphic disorder
 Pain disorder
 Undifferentiated somatoform disorder - only one unexplained symptom is
required for at least 6 months.

Included among these disorders are false pregnancy, psychogenic urinary retention,
and mass psychogenic illness (so-called mass hysteria).

 Somatoform disorder Not Otherwise Specified (NOS) [2]