SCHIZOPHRENIA

CHARACTERISTICS OF SCHIZOPHRENIA

• DMS- IV has a multiple part process for

determining whether some one does or does
not have schizophrenia
• Positive symptoms refer to more active
manifestations of abnormal behaviour or an
excess of distortion of normal bahaviours,
these include delusions, hallucinations and
disorganized speech
• Negative symptoms involve deficit in normal
behaviour or such dimensions as affect speech
and motivation.
• A diagnosis of schizophrenia requires that two
or more of these positive and/or negative
symptoms are present for at least one month.
POSITIVE SYMPTOMS OF SCHIZOPHRENIA

A. Delusions
A belief that would be seen by most of members
of a society as a misrepresentation of reality is
called a disorder of thought,

• called as basic characteristic of madness

Common types of delusions are –
I. Persecutory delusions
II. Delusions of reference
III. Grandiose delusions
IV. Delusions of thought insertions
I) Persecutory Delusions :- Individual suffering
from these delusions constantly feel that they
are being watched or tormented by people
whom they know such as professors (in case
of students), CBI who are involved in hard core
crime or any other authoritative figure.
ii) Delusions Reference :- Individual suffering
from this type of delusion believe that random
events, comments passed by others are
aimed at them. People with delusion of
reference may feel that a politician is trying to
harm him personally through speech.
iii) Grandiose Delusions :- Individual suffering
from this delusion feel that they are special
person and have magic powers. They may
consider them selves as the most intelligent,
insightful and creative person on planet
earth. They may think that they are great
historical characters and think they have
discovered the cure of an incurable disease.
iv) Delusion of Thought Insertions :- Individual
suffering from this delusion feel that their
thoughts are being controlled by out side
forces (e.g., serial killers or terrorists).
 b) Hallucinations
• The experience of sensory events without any
input from surrounding environment
Types of Hallucinations :-
I. Auditory Hallucinations
II. Visual Hallucinations
III. Tactile Hallucinations
IV. Somatic Hallucinations
I)Auditory Hallucinations :- In auditory
hallucinations individuals hear heavy voices,
music, different type of noises, which are
imaginary and not existing. Women are more
prone to it than men.
ii) Visual Hallucinations :- An individual suffering
from this may see a ghost coming out of T.V.
and talking to him.
iii) Tactile Hallucinations :- It involves a feeling
that some weird thing in happening to one‘s
body . E.g., insects are crawling allover his
body.
iv) Somatic Hallucinations :- It involves feeling
that some thing in happening inside one‘s
body and they are tickling him from within.
 c) Disorganized speech
• often lack insight that they have disease.
• The most commonly found disorganised
tendency in to slip from one topic to a totally
unrelated topic. There in no association
between topics discussed by them. This is also
known as derailment of thought.
NEGATIVE SYMPTOMS OF SCHIZOPHRENIA

(a) Flat Affect --do not show emotions

• stare at you with vacant eyes, speak in a flat
and toneless manner and seems to be
unaffected by things going on around them.
This condition in also known as blunted affect
 difficulty with expressing emotion and an
inability to feel the emotion.
(b) Avolition -inability to initiate and persist in
many important activities
• unmotivated, disorganised and careless in the
task that they undertake.
• Aphaty
(C) Alogia --relative absence in either the
amount or the content of speech , a delayed
comments or slow response to the questions
OTHER SYMPTOMS OF SCHIZOTHRENIA

(a) Inappropriate Affect :- The schizophrenic

patients may react with an inappropriate
emotion to a particular action, e.g., individual
may cry when it is time to laugh and vice-
versa.
(b) Anhedonia --loss of enjoyment for activities
that would typically be considered,
pleasurable, including eating, social relations,
sexual interactions
• They lack feeling of both happy and sad
emotions.
(c) Impaired Social Skills :- Most of the
schizophrenic patients show poor social skills,
such as difficulty in maintaining conversation,
job and relationship.
 THEORIES OF SCHIZOPHRENIA
Two broad categories –
1. Biological Theories
2. Psycho – social Theories
Biological theories are sub – divided into several categories
–
1. Genetic Influences on Schizophrenia.
2. Neurotransmitters– high dopamine
3. Structural Brain Abnormality
4. Birth complications
5. Prenatal Viral Exposure
 2) Psycho- Social Theories
a) Psychodynamic Perspective
b) Communication Patterns
c) Expressed Emotions
d) Stress and Relapse
e) Behavioural and Cognitive Perspective
f) Cross – Cultural Perspective
 A)Psycho dynamic
• negative childhood experiences -Poor
parenting
• when mothers behave extremely harsh
towards their child and when they do not
express love to their child then the child
regresses and shows infantile tendencies while
carrying out the daily functioning. This
becomes unhealthy for the Ego to discriminate
between reality and unreality
 B) Communication patterns
• If the parent communicates messages that
have two conflicting meanings (for example, a
mother responding coolly to her child‘s
embrace, but saying ―Don‘t you love me
anymore?‖ when the child withdraws
 c) Expressed Emotions
• criticism (expressing disapproval), hostility
(expressing animosity), and emotional
overinvolvement (being intrusive) by the
families was high, patients tended to relapse (
 D) Stress and relapse
• link between ―Urban lifestyle
e) Stress and Relapse
f) Behavioural and Cognitive Causes --Because
of inadequate parenting or due to some
unfortunate circumstance they learn
irrelevant, inappropriate and socially
unacceptable responses towards others
around them---operant conditioning
 TREATMENT OF SCHIZOPHRENIA
BIOLOGICAL TREATMENT : DRUG THERAPY
Clozapine
PSYCHO – SOCIAL TREATMENTS OF
SCHIZOPHRENIA --social learning theory, operant
conditioning and modeling
Family therapy - Family members are trained to
deal with the patient in the family. They are
made aware of the causes of this disorder,
symptoms and the side effect of the drug therapy
Assertive Community Treatment Programs
Cross – Cultural treatments - Traditional
Healers
• Strong evidence for effectiveness
•Antipsychotic medications
•Family psycho education
•Assertive Community Treatment (ACT teams)
• Psychotherapy individual, group behavioral,
supportive, or family therapy may be used.
• Milieu therapy – structured environment is used
to minimize environmental and physical stress
and to meet the individual needs of the p.t until
he is able to a assume responsibility for him self
• Chemotherapy: Antipsychotic drugs or major
tranquilizers (e.g. Haldol, stelazine mallaril etc)
may be prescribed.