SCHIZOPHRENIA

DIVYANSHI
SEM-1V
864
INTRODUCTION

The name schizophrenia derives from the early observation that the illness is typified by the
disconnection or splitting of the psychic functions. The schizophrenic disorders are characterized in
general by fundamental and characteristic distortions of thinking and perception. If we
understand in simple language it is schizophrenia is a type of mental illness that affects how the
brain works. This leads to chronic problems with disordered thoughts and behaviors. The most
important psychopathological phenomena include thought echo; thought insertion or withdrawal;
thought broadcasting; delusional perception and delusions of control; influence or passivity;
hallucinatory voices commenting or discussing the patient in the third person; thought disorders
and negative symptoms.
 AETIOLOGY

There are many factors associated in developing schizophrenia –

including genetics, early environment, neurobiology,
and psychological and social processes—
the exact cause of the disease is unknown.
 EPIDEMIOLOGY

• Schizophrenia affects an estimated 1 percent of the population.

• Schizophrenia most commonly has its onset in late adolescence or early
adulthood and rarely occurs before adolescence or after the age of 40
years. The peak ages of onset are 20–38 years for males and 26–32 years
for females.
• Schizophrenia is slightly more common in men than in women.
 CONCEPT OF HALLUCINATION AND DELUSION

Hallucination:
Hallucinations are sensory experiences that appear real but are created
by your mind. They can affect all five of your senses. For example, you
might hear a voice that no one else in the room can hear or see an image
that isn’t real. It is a perception in the absence of external stimulus that
has qualities of real perception.  Hallucinations have been defined as the
"perception of a nonexistent object or event" and "sensory experiences
that are not caused by stimulation of the relevant sensory organs."
 TYPES OF HALLUCINATION

•Auditory: This is the most common type of hallucination. You may hear voices
or sounds that no one else can.3
•Visual: You may see people, colors, shapes, or items that aren't real. This is
the second most common type of hallucination.
•Tactile: You may feel sensations or feel like you're being touched when you're
not. This can include a feeling of bugs crawling all over you or under your skin.
These hallucinations rarely occur in bipolar disorder.
•Olfactory: You smell something that no one else can and that has no physical
source. This type is less common than visual and auditory.
•Taste: You have a taste in your mouth that has no source. This is the rarest
type of hallucination.
 DELUSION

• Delusion is a persistent false psychotic belief regarding the self or

persons or objects outside the self that is maintained despite
indisputable evidence to the contrary. These are unshakable beliefs in
something untrue. People with delusional disorder experience non-
bizarre delusions, which involve situations that could occur in real life,
such as being followed, poisoned, deceived, conspired against, or loved
from a distance. These delusions usually involve the misinterpretation
of perceptions or experiences. In reality, however, the situations are
either not true at all or highly exaggerated.
 TYPES OF DELUSION

• Persecutory delusion or delusion of paranoia

This is the most common form of delusional disorder. In this form, the
affected person fears they are being stalked, spied upon, obstructed,
poisoned, conspired against or harassed by other individuals or an
organization.
• Delusion of grandeur
In this form of delusion, the person believes they are much greater or
more influential than they really are. For example, they may be
convinced they have an exceptional talent, extravagant riches.
• Delusion of jealousy
This usually develops due to a fear that a spouse or partner is being unfaithful. These
doubts may be unfounded and can cause severe damage to the relationship. Studies have
shown that this form of delusion is more common in men than in women.
• Erotomania or delusion of love
In this form of delusion, the patient is often firmly convinced that a person he or she is
fixated upon is in love with them. This obsession leads to stalking, unnatural jealousy and
rage when the object of their affection is seen with their spouse or partners. It is often
concern a famous person or someone who is in a superior status and usually there is no
contact between the patient and the victim, who has never encouraged the patient.
 TYPES OF SCHIZOPHRENIA

Paranoid schizophrenia
Paranoid schizophrenia is dominated by relatively stable, often paranoid delusions,
usually accompanied by hallucinations, particularly of the auditory variety, and
perceptual disturbances. It may develop at a later age than other types of
schizophrenia. Speech and emotions may be unaffected. It leads to the risk for
suicidal or violent behavior under influence of delusions.

Simple schizophrenia
• Considerable loss of personal drive.
• Progressive deepening of negative symptoms.
• Pronounced decline in social, academic, or employment performance.
HEBEPHRENIC SCHIZOPHRENIA OR DISORGANIZED SCHIZOPHRENIA
• A form of schizophrenia in which affective changes are prominent, delusions
and hallucinations fleeting and fragmentary, behaviour irresponsible and
unpredictable, and mannerisms common. The mood is shallow and
inappropriate, thought is disorganized, and speech is incoherent. Hebephrenia
should normally be diagnosed only in adolescents.
• Symptoms include disorganised behaviours and thoughts, alongside short-
lasting delusions and hallucinations. You may have disorganised speech
patterns and others may find it difficult to understand you.
• People with disorganised schizophrenia often show little or no emotions in their
facial expressions, voice tone, or mannerisms. At times they have inappropriate
emotional responses to the situation, such as laughing at something sad.
CATATONIC SCHIZOPHRENIA

• This is the rarest schizophrenia diagnosis, characterised by unusual,

limited and sudden movements. You may often switch between being
very active or very still. You may not talk much, and you may mimic
other’s speech and movement.
• Constrained attitudes and postures may be maintained for long
periods. Episodes of violent excitement may be a striking feature of the
condition. The catatonic phenomena may be combined with a dream-
like state with vivid scenic hallucinations.
UNDIFFERENTIATED SCHIZOPHRENIA

Diagnosis may have some signs of paranoid, hebephrenic or catatonic schizophrenia, but it doesn’t
obviously fit into one of these types alone. Psychotic conditions meeting the general diagnostic
criteria for schizophrenia but not conforming to any of the subtypes

RESIDUAL SCHIZOPHRENIA
A chronic stage in the development of a schizophrenic illness in which there has been a clear
progression from an early stage to a later stage characterized by long- term, though not
necessarily irreversible, "negative" symptoms. psychomotor slowing; underactivity; passivity and
lack of initiative; poverty of quantity or content of speech; poor nonverbal communication by facial
expression, eye contact, voice modulation and posture; poor self-care and social performance.
 
SYMPTOMS
POSITIVE SYMPTOMS

Positive symptoms are active problems that shouldn’t be present (like hallucinations). They are
"positive" in the sense that they represent an addition to someone's typical day-to-day experience.
• Hallucinations: During a hallucination, a person hears, sees, feels, or smells something that is
not actually present. Most often this occurs in the form of hearing voices that others do not hear.
These voices may be reassuring, threatening, or anything in between. Sometimes a person
experiences these only as intrusive thoughts, but often they seem to come from outside the self.
• Delusions: Delusions are false beliefs held by a person that are not shared by other people.
Someone with a delusion has a very fixed view of a situation and cannot be talked out of it with
reason. For example, someone with schizophrenia might believe he is the subject of a government
conspiracy.
• Disorganized Speech: People with disorganized speech may be
difficult to understand because their sentences are unconnected or
because the person is frequently switching topics in a way that doesn’t
make sense to the listener. However, the speech may have meaning for
the individual in a way that is connected to their internal experience.
• Lack of insight: Failure to appreciate that symptoms are not real or
caused by illness.
NEGATIVE SYMPTOMS

Characteristics that seem to be absent or diminished in someone with schizophrenia

are called negative symptoms. Negative symptoms of schizophrenia can include:
• Decreased emotional expression
• Lack of initiation in goal-directed activities
People may also have additional cognitive symptoms like difficulty concentrating,
remembering, or planning activities. People with schizophrenia may also have poor
self-care and poor interpersonal, school, or career functioning. The illness also
makes it more challenging for the individual to join in social events, and participate
in meaningful relationships.
• Alogia, or poverty of speech, is the lessening of speech fluency and productivity, thought to
reflect slowing or blocked thoughts, and often manifested as short, empty replies to questions.
• Affective flattening is the reduction in the range and intensity of emotional expression,
including facial expression, voice tone, eye contact (person seems to stare, doesn't maintain
eye contact in a normal process), and is not able to interpret body language nor use
appropriate body language.
• Avolition is the reduction, difficulty, or inability to initiate and persist in goal-directed
behavior; it is often mistaken for apparent disinterest. (examples of avolition include: no longer
interested in going out and meeting with friends, no longer interested in activities that the
person used to show enthusiasm for, no longer interested in much of anything, sitting in the
house for many hours a day doing nothing.
COGNITIVE SYMPTOMS

Cognitive symptoms refer to the difficulties with concentration and memory.

These can include: disorganized thinking
• slow thinking
• difficulty understanding
• poor concentration
• poor memory
• difficulty expressing thoughts
• difficulty integrating thoughts, feelings and behavior
 COGNITIVE BEHAVIOURAL THERAPY

Cognitive behavioral therapy, also known as CBT, may be a treatment

option for people with schizophrenia. CBT teaches a person to modify
beliefs or behaviors that may be leading to negative emotions. The
therapy has two main parts: a cognitive component, which helps a
person to change his or her thinking about a situation, and a behavioral
component, which helps a person to change his or her reactions.
Cognitive behavioral therapy can also help people with schizophrenia to
develop better social and problem-solving skills. The therapist teaches
the person how to test the reality of his or her thoughts and perceptions,
ignore any voices, and manage symptoms.
THANK YOU !
Divyanshi
Sem- 1V
864