1. Schizophrenia
Chapter 12

2. Schizophrenia
2 or more of the following, present for a significant portion of time during a 1-month period, at least one must be delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms
Significant portion of time since onset the level of functioning in one or more major areas such as work, interpersonal relations, or self-care is below the level achieved prior to onset
Persist for at least 6 months
Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out
Not attributable to substance use
If ASD- dx if prominent delusions or hallucinations in addition to other required symptoms are present for at least 1 month

3. Some words that are often used
Catatonia- a disorder of movement involving immobility or excited agitation
Hebephrenia- a silly and immature emotionality, a characteristic of some types of schizophrenia
Paranoia- irrational beliefs that they are especially important (delusions of grandeur) or that other people are seeking to do them harm
Dementia praecox- Latin term meaning premature loss of mind; an early label for what is now called schizophrenia- emphasizing the disorder’s frequent appearance during adolescence
Associative splitting- a separation among basic functions of human personality (cognition, emotion, perception) seen by some as the defining characteristic of schizophrenia
Psychotic behavior- hallucinations and loss of contact with reality

4. Cont
Positive symptom- a more overt symptom such as a delusion or hallucination displayed by some with schizophrenia
Delusions- a psychotic symptom involving disorder of thought content and presence of strong beliefs that are misrepresentations of reality
Hallucination- a psychotic symptom of perceptual disturbance in which something is seen, heard, or otherwise sensed although it is not actually present
Negative symptoms- a less outgoing symptom, such as flat affect or poverty of speech, displayed by some with schizophrenia
Avolition- an inability to initiate or persist in important activities (apathy)

5. Cont.
Alogia- a deficiency in the amount or content of speech, often seen in schizophrenia
Anhedonia- an inability to experience pleasure, associated with some mood and schizophrenic disorders
Flat affect- an apparently emotionless demeanor (including toneless speech and vacant gaze) when a reaction would be expected
Disorganized speech- a style of talking often seen in people with schizophrenia, involving incoherence and a lack of typical logic patterns
Inappropriate affect- an emotional display that is improper for the situation
Catatonic immobility- a disturbance of motor behavior in which the person remains motionless, sometimes in an awkward posture for extended periods

6. Schizophreniform Disorder
2 or more, each present for a significant portion of time during a 1-month period, at least one of these must be delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms
An episode lasts at least 1 month but less than 6 months
Schizoaffective, depressive, bipolar w/psychotic features ruled out
Disturbance not form substance use
Specify-
Good prognostic features- 2 of the following: onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in usual behavior or functioning, confusion or perplexity, good premorbid social/occupational functioning, absence of blunted or flat affect
Without good prognostic features: 2 or more of the above features have not been present

7. Schizoaffective Disorder
An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia
The major depressive episode must include Criterion A1: depressed mood
Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness
Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness
Not attributed to the effects of a substance

8. Delusional Disorder
Present of 1 or more delusions with a duration of 1 month or longer
Criterion A for schizophrenia has never been met
Apart form the impact of the delusions or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd
If manic or mde have occurred, these have been brief relative to the duration of the delusional periods
Not attributable to substance use

9. Types
Erotomanic type-delusion that another person is in love with the individual
Grandiose type- delusion of having some great (but unrecognized) talent or insight or having made some important discovery
Jealous type- delusion that the individual’s spouse or lover is unfaithful
Persecutory type- delusion that the individual is being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals
Somatic type- delusions that involve bodily functions or sensations
Mixed type- no delusional theme predominates
Unspecified type- cannot be clearly determined or not described by the specific types

10. Others Substance/medication induced Brief Psychotic Disorder
Psychotic Disorder associated with another medical condition