Schizophrenia psychosis broad term implies psychotic symptoms i e hallucinations delusions schizophrenia a type of psychosis schizophrenia is not caused by poor parenting and is not split personality at least 2 of the following delusions hallucinations disorganized speech grossly disorganized or catatonic behavior negative symptoms like flat affect or avolition at least 1 must be delusions hallucinations or disorganized speech signs of the disturbance must persist for at least 6 months and at least one month must be active phase symptoms stuff in blue positive symptom cluster active manifestation of abnormal behavior distortions of normal behavior 50 70 of people with schizophrenia display these symptoms delusions irrational beliefs gross misrepresentations of reality fixed beliefs that are not amenable to change in light of conflicting evidence can be erotomanic having to do with love believing that a stranger or high status person is in love with you Obama is in love with me he s directing things to me in his speeches I will write love letters back to him grandiose fantastical beliefs that you re famous wealthy powerful I was destined to be president and that s the track I m on it s just a matter of time can have to do with imagined relationships w famous people but is more about thinking you re destined for level of success higher than what you re actually destined for jealous constantly convinced that partner is unfaithful even with absolutely no evidence persecutary you or someone close to you is being persecuted in some way i e you re being drugged spied on etc because of this delusion you might act out like punching someone who you think is targeting you somatic you feel like you re afflicted with a terrible medical condition 2 theories of delusions motivational delusions are an attempt to deal with make sense of and relieve anxiety and stress and deficit delusions result from brain dysfunction that creates these disordered cognitions or perceptions hallucinations involuntary experience of sensory events without environmental input very vivid can involve all senses findings from SPECT studies show that Broca s area production of language is activated during auditory hallucinations suggest that people with schizophrenia may not actually be hearing voices but are just having trouble distinguishing between their own thoughts supports metacognition theory that people who are hallucinating are not hearing voices of others but are listening to their own thoughts and cannot recognize the difference so the way that someone may report hearing voices may not match what s happening physically one possible explanation for this problem is poor emotional prosody comprehension inability to determine meaning and emotion of spoken language as communicated through pitch amplitude pauses etc in these people most common are auditory hallucinations voices feel separate from your thoughts can t stop them very distracting negative symptom cluster absence or insufficiency of normal behavior 25 of people with schizophrenia display these symptoms spectrum of negative symptoms avolition apathy lack of initiation motivation persistence or willingness so for example not showering out of a lack of interest in doing so alogia relative absence of speech gives short responses talks very little anhedonia lack of pleasure or indifference to activities affective flattening not showing any emotions on their face not that they don t feel them just that they don t express them of people w schizophrenia show this symptom disorganized symptom cluster severe and excess speech behavior and emotion disorganized speech cognitive slippage illogical and incoherent speech tangentiality when someone goes off on a tangent you ask them about something and they go off on a tangent talking about something else w out returning to original topic tangential sometimes they do come back to original topic circumstantial loose associations switching from one topic to another over the period of a few minutes disorganized affect inappropriate emotional behavior laughing or crying at inappropriate times disorganized behavior the way they re dressed pacing quickly catatonia moving fingers wildly not moving at all motor dysfunctions that range from wild agitation to immobility something about their behavior feels disorganized spectrum of symptoms in DSM IV there were 3 subtypes of schizophrenia in DSM 5 they eliminated subtypes and instead decided to better describe different symptoms that people were experiencing more dimensional than categorical on a spectrum DSM 5 focuses on a dimensional approach to rating severity of the core symptoms even within the subtypes there was tons of heterogeneity so there was no point in having them also people often moved from one subtype to another general info schizophrenia is generally chronic people don t usually spontaneously recover lifetime course including prodromal stage unusual psychotic like behaviors about a year before onset of schizophrenia they start isolating more shifts in functioning like not doing well at work having less energy or less interest prognosis usually emerges in early adulthood although can emerge at any time men usually start going through a psychotic episode in early mid 20s and for women it tends to be in late 20s among those w late onset most are women most suffer moderate to severe impairment throughout life life expectancy is lower than average for people w schizophrenia partially due to higher risk of suicide than in those without schizophrenia people do typically improve with treatment but a majority will relapse at least once for about 20 of people there is a favorable prognosis and a smaller amount of these people will report complete recovery most people w schizophrenia would require daily living support whether it s a parent someone in a hospital etc it s difficult for many of them to work children who later go on to develop schizophrenia show early clinical features like mild physical abnormalities poor motor coordination and mild cognitive social problems however these problems are not specific to schizophrenia they also precipitate other kinds of disorders so they can t predict schizophrenia slightly more males have schizophrenia but it s roughly equivalent prevalence 0 3 0 7 in the US African Americans tend to be diagnosed more than Caucasians in other countries the minority ethnic group tends to be diagnosed more than the majority ethnic group may be the