1. Characteristics of Psychotic Disorders

2. CLINICAL CHARACTERISTICS OF SCHIZOPHRENIA

3. Learning objectives You must: You should: You could also:
Identify two or more clinical characteristics of schizophrenia
Know and explain differences in the prevalence of this disorder in different populations
You should:
Explain the differences between Type 1 and Type 2
You could also:
Outline the difficulties when making a diagnosis

4. WHAT IS SCHIZOPHRENIA? Schizophrenia is not a multiple personality
It is a psychotic disorder characterized by the loss of contact with reality
It has many different manifestations
with a few shared features
formerly referred to as:
Lunacy, madness or insanity

5. NEUROSIS PSYCHOSES NEUROSIS OR PSYCHOSES?
Mental health issues that fall just outside normal functioning but the individual is in touch with reality and knows they are ill
PSYCHOSES
Mental health issues where the individual has lost touch with reality and is not on a continuum with normal mental health

6. CLASSIFICATION POSITIVE SYMPTOMS – TYPE 1 NEGATIVE SYMPTOMS – TYPE 2
Distortion of normal function
NEGATIVE SYMPTOMS – TYPE 2
Lack of normal function
Delusions, hallucinations, disorganised speech, under the
control of an alien force, disordered thinking
Apathy, no emotion, flat effect, social withdrawal, Alogia

7. There are more than these but these are the main ones
SUB TYPES
PARANOID
Delusions, persecution, hallucinations
CATATONIC
Immobile, catatonic stupors
Wild, uncontrolled movements
DISORGANISED
Giggling, pulling faces,
flat effect.
RESIDUAL
low level positive symptoms but psychotic symptoms present
UNDIFFERENTIATED
Does not fit into any of above
There are more than these but these are the main ones

8. ACTIVITY
Difficulties in categorizing and forming a diagnosis

9. DIAGNOSIS ICD & DSM Can only be done by a psychiatrist
As yet there is no physical way to diagnose
Current research is looking at blood test or eye tracking

10. ACTIVITY
Find & Outline the ICD / DSM clinical Characteristics.

11. Schizophrenia prevalence
1% lifetime risk in general population
Holds true for most geographical areas although rates do vary
Abnormally high in Southern Ireland, Croatia; significantly lower rates in Italy, Spain (Torrey, 2002)
Risk factors include minority ethnicity, urban residence
How might differences in rates of diagnosis be explained?

12. Schizophrenia onset
Source: CIHI (2001)

13. PROGNOSIS ‘Rule of the thirds’ (rule of thumb):
1/3 recover more or less completely
1/3 episodic impairment
1/3 chronic decline
With treatment about 60% of patients manage a relatively normal life
Prognosis better in non-industrialised societies

14. Homework
Schizophrenia work pack