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Schizophrenia and Phenomenology (ICD classification of Schio and other…
Schizophrenia and Phenomenology
Pyschopathology : systematic study of abnormal experiences, cognition and behaviour
Explanatory psychopathology: includes; psychodynamic behavioural and cognitive theories
Descriptive psychopathology: involves direct observation of behaviour and the empathic assessment of subjective experiencs= phenomenology
primary and secondary symptoms
what comes first and what comes second
Form and content
content - the theme of conversation
form: belief, delusional, overvalued idea, real belief, own thoughts, hallucination (auditory etc) , pseudohallucination (between own thoughts and other voice)
Psychosis
Delusions, hallucinations and formal thought disorder
positive psychotic symptoms
delusions, hallucinations, thought disorder
respond well to drugs
negative psychotic symptoms
deficits. anhedonia, flattened affect, social withdrawal, lack of drive and social skills, poverty of speech, lack of interest in personal appearance, poor self care
flattened affect ( no reaction to emotional stimuli). "blunted" is a lesser form
don't respond well to drugs
Schneiderian First Rank Symptoms : a list of symptoms which are found more commonly in schizophrenia than other conditions
ICD classification of Schio and other psychotic disorder
Other Non-organic psychotic disorder
Unspecified non-organic psychosis
Schizoaffective disorder
symptoms of schizo in other diagnosis??? (e.g. Bipolar,manic psychosis)
induced delusional disorders
e.g. child living with parent with schizo and adopts their beliefs
acute and transient psychotic disorderes
Persistent elusional disorder
Schizotypical disorder
Schizophrenia
1 in 5 will have complete recovery after initial episode. 10% suicide rate, typically early in diagnosis.
aeitology
Genes, drugs, intrauterine,perinatal events, social
First Rank Symptoms
primary delusions
Delusions of control
3rd person auditory hallucinations( 3rd=Charlotte/She, 2nd=you, 1st=I): thought echo, voices arguing or discussing the pt voices commenting on actions
somatic hallucinations
delusions of thought control or "subject thought disorder"(different from formal thought disorder). Thought insertion, thought withdrawal(empty head), thought broadcast (thoughts diffuse)
ICD 10
1 month
one of:
delusions of control, primary delusion
third peron aud hallucination
thought echo, thought insertion/withdrawal/broadcast
persistant bizzare delusions that are impossible
or two of
Subtypes (can change, just words for dom feature of this episodes)
Post-schizophren depression
undifferentiated
Simple: chronic symptoms with no clear episodes of primary symptoms
Residual ("chronic") predom negative symptoms for at least a year
Hebephrenic (disorganized)
Catatonic. dominated by psychomotor disturbances - stupor, excitment, posturing, negativisim, rigisity, waxy flexibility, command automatism
Paranpid - prom hallucinations and delusions
Hallucination
Perception-like experience in the absence of an external stimulus
has the full force and impact of a real perception
is unwilled, spintaneous and cannot be controlled readily
Consciousness is clear ( cf Hypnogogic and hypnopompic pseudohallucinations)
Illusion (not psychotic)
with sensory stimulus. Mistaking objects etc
sensory distortion( not psychotic): when an object is the same but altered, colour, size etc
Pseudohallucination
not necessarily pathological
different meanings
factitious (lying) in malingeres
typical hallucinations of bereavement states
Hs in drug withdrawal and intoxication states
True hallucinations with insight (Hare'73)
Hallucinations located in inner subjective space/mind's eye
perceptions which on't fit other categories or fulfil all the criteria for halluination