⦿ an estimated 1% of population has Schizophrenia.
⦿ In DSM-5 Schizophrenia is defined as :
1. a group of characteristic positive or negative symptoms,
2. deterioration in social, work or interpersonal relationships &
3. continuous signs of the disturbance for at least 6 months.
Dimensional Approach to Schizophrenia:
There are 3 symptoms dimensions:
1. Psychotic Dimension
2. Disorganization Dimension
3. Negative Dimension.
1. Psychotic Dimension
(i) Hallucinations :
Hallucinations are the perceptions experienced without an external stimulus with a quality similar to a true perception.
(ii) Delusions:
Delusions are firmly held beliefs that are untrue, as well as contrary to person’s educational and cultural background.
2. Disorganization Dimension
(i) Disorganized speech or thought disorder:
- Derailment (Loosening of Association)
- Poverty of speech
- Poverty of content of speech
- Tangentiality
- Perseveration
- Distractibility
- Neologism
- Echolalia
- Thought blocking
(ii) Disorganized Motor & Social Behavior
(a) Disorganized Motor Behaviour:
- Catatonic stupor: immobile, mute & unresponsive yet conscious
- Catatonic excitement: Uncontrolled & aimless motor activity
- Stereotypy: Repeated non-goal directed activity.
- Grimacing
- Echopraxia: Imitating movements & gestures of another person.
- Automatic obedience: Carrying out simple commands in a robot like fashion.
- Negativism: refusing to cooperate with simple requests for no apparent reason.
(b) Disorganized social behaviour:
- Poor Personal Hygiene
- Masturbating in public
- Shouting obscenities
(iii) Incongruity of affect:
- Patient may smile inappropriately on sad topics.
- Giggle for no apparent reason.
3. Negative Dimension
Five A’s :
(i) Affective Flattening/blunting
(ii) Avolition : loss of ability to initiate goal directed activity & carry it through to completion.
(iii) Alogia : poverty of speech.
(iv) Anhedonia : inability to experience Pleasure.
(v) Attention Impairment.
Reference:
- Oxford Handbook of Psychiatry (3rd edition) https://amzn.to/3rsJxse