1. Schizophrenia

2. A. Two or more of the following, each present for a significant portion of the time during a 1-month period** 1. Delusions 2. Hallucinations 3. Disorganized speech 4. Grossly disorganized or catatonic behavior 5. Negative symptoms

3. Schizophrenia **Exception to the 2+ symptom requirement: only 1 psychotic symptom required if: 1. Delusion is bizarre OR 2. Hallucination consists of either: a. voice keeps up a running commentary on the person’s thoughts or behavior OR b. two or more voices conversing with each other

4. Schizophrenia B. Impairment in functioning C. Signs of the disturbance for at least 6 months, that includes at least 1 month of symptoms described by Criterion A D. Symptoms are not better accounted for Schizoaffective Disorder or Mood Disorder with Psychotic Features E. Not due to a GMC or substance F. If there is a developmental disorder present, there are prominent delusions or hallucinations present for at least one month

5. Delusions (Positive Symptom)  Fixed, false beliefs  Types Bizarre –delusion that is very strange and completely implausible for the person's culture; an example of a bizarre delusion would be that aliens have removed the affected person's brain vs. the non-bizzare delusion that you’re under police surveillance Thought insertion –thoughts are being inserted into his or her mind from some outside force, person, or group of people, and these thoughts are not recognized as the person's own thoughts Thought withdrawal – Thought broadcast – Reference – believes that insignificant remarks, events, or objects in one's environment have personal meaning or significance

6. Delusions (positive symptom)  Types, continued Control –another person, group of people, or external force controls one's thoughts, feelings, impulses, or behavior. Somatic – Usually the false belief is that the body is somehow diseased, abnormal, or changed. An example of a somatic delusion would be a person who believes that his or her body is infested with parasites. Nihilistic – Belief that something is about the to end. You or the world Grandiose –An individual exaggerates his or her sense of self-importance and is convinced that he or she has special powers, talents, or abilities. Sometimes, the individual may actually believe that he or she is a famous person (for example, a rock star or Christ). More commonly, a person with this delusion believes he or she has accomplished some great achievement for which they have not received sufficient recognition. Religious –Any delusion with a religious or spiritual content. Persecutory –These are the most common type of delusions and involve the theme of being followed, harassed, cheated, poisoned or drugged, conspired against, spied on, attacked, or obstructed in the pursuit of goals.

7. Hallucinations (Positive Symptom)  False sense perception  Types Auditory – Tactile – Visual – Olfactory/Gustatory – Somatic –

8. Disorganized Speech (Positive Symptom)  Speech that is hard to understand or follow, impairs communication  Types Loose associations – Incoherence – Frequent derailment –

9. Disorganized Speech: Geometric Analogy QA A A A Q Q Q Normal: goal directed and linear Tangential Loosening of Associations Incoherence A Q Circumlocution

10. Grossly Disorganized or Catatonic Behavior (Positive Symptom)  Grossly Disorganized Behavior Unusual behavior in which the individual acts any number of ways from silly and childlike to angry and aggressive.

11. Grossly Disorganized or Catatonic Behavior (Positive Symptom)  Catatonic Behavior

12. Negative Affect (Negative Symptom)  Flat affect  No emotional expression in speech  Restricted fluency of thought and speech

13. Schizophrenia: Course Group 3 30% have repeated episodes of illness with some impairment between episodes Group 2 25% have repeated episodes of illness with no impairment between episodes Group 1 15% have only a single episode of illness with no subsequent impairment Group 4 30% have repeated episodes of illness with gradually declining impairment between episodes

14. Subtypes of Schizophrenia  Paranoid  Disorganized  Catatonic  Undifferentiated  Residual

15. Catatonic

17. Paranoid Schizophrenia  Preoccupation with one or more delusions or auditory hallucinations (usually persecutory, grandiose, or both)  None of the following is prominent: Disorganized speech, Disorganized behavior Catatonic behavior Flat/inappropriate affect

18. Disorganized Schizophrenia  All of the following are prominent Disorganized speech Disorganized behavior Flat/Inappropriate affect  There is no catatonic behavior

19. Catatonic Schizophrenia  A type of Schizophrenia in which the clinical picture is dominated by at least 2 or more catatonic behaviors Motoric immobility as evidenced by stupor, catalepsy, or waxy flexibility Excessive motor activity that is apparently purposeless and not influenced by external stimuli Extreme negativism or mutism Peculiarities of movement (posturing, stereotyped movements, prominent mannerisms, or prominent grimacing Repeating whatever is said or done

20. Undifferentiated Schizophrenia  Characterized by symptoms which do not fit the paranoid, disorganized, or catatonic subtypes  Vague, “catch-all” category