Thursday, April 19, 2007

Since You Asked: Schizophrenia

Schizophrenia involves dysfunction in one or more major areas:

interpersonal relationships
education, or

Typically functioning is below what it was prior to the onset of the illness. In children and adolescents, educational progress is disrupted, adults can't usually continue to work.

Schizophrenia is one of the psychotic disorders and is a disturbance that lasts for at least 6 months* and includes at least 1 month of 2 or more of the following:

often persecutory, I'm being tormented, tricked, spied on;
referential, certain gestures, articles in the newspaper are aimed at me; someone has replaced my kidneys while I was asleep;
thought insertion, an alien is telling me what to think, or
thought depletion- an alien has taken my thoughts

these beliefs, cognitions, experiences aren't funny, they're terrifying


generally auditory, hearing voices,
sometimes one or two voices that are discussing a sufferer's thoughts,
sometimes they tell the sufferer what to do, i.e., shoot someone;

other hallucinations affect the other senses:
olfactory (smells),
gustatory (taste),
and tactile (bugs are crawling on me).

Some studies indicate that the brain really does light up in these areas when a person is experiencing a hallucination.

Hallucinations can occur in the absence of schizophrenia, I (therapydoc) sometimes feel there's an ant on me when there isn't, but actually, sometimes there is. Avoid dry skin, perhaps is the solution

disorganized thinking
derailment or loose associations,

answers that are not related to the question,

sometimes speaks aphasic, as in "word salad" or incoherence that is severe enough to impair effective communication

grossly disorganized behavior-
ranges from childlike silliness to unpredictable agitation

inability to stay on tasks, such as making meals

doesn't, can't attend to hygiene

appears disheveled or wears unusual attire (many coats)

catatonic motor behavior -
a marked decrease in reactivity to the environment
rigid posture
resists efforts to be moved
is in a stupor

negative symptoms
affective flattening- a person's face appears immobile, unresponsive, poor eye contact, reduced body language;

alogia is poverty of speech, manifested by brief, laconic, and empty replies (or none at all), due to lack of thoughts or decreased fluency;

avolition, characterized by an inability to initiate and persist in goal directed activities

The features can't be explained by another disorder (such as Bi-polar Disorder), a general medical condition, or the effects of a drug.

That's it in a very large nutshell, but there is much more for you to know.

*all of this material, except for my examples and commentary is in the Diagnostic Statistical Manual, or DSM IV-TR, American Psychiatric Association