1. Clinical Psychology Unit 4
Describe the features and symptoms of
Schizophrenia

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. 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

6. EVALUATION Positive symptoms Negative symptoms
Can be affected by cultural differences
Tend to have greater weight when diagnosing
Hard to measure objectively
Negative symptoms
Start before positive ones
Sometimes start years before diagnosis
Less affected by cultural factors
More objectively measured

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. Cut and Stick activity

9. EVALUATION OF SUBTYPES
Lacks precision
People don’t fit neatly into one or other subtype
Categorising people gives little or no indication of:
Cause
How it might develop
Effective treatment

10. DIAGNOSIS Requires two or more POSITIVE symptoms
For a period of at least a month
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

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

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