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1. Nick & Bethan Redshaw 7 Schizophrenia Schizophrenia is a serious mental health condition. In men the condition usually begins between 15 and 30 years of age and in…
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  • 1. Nick & Bethan Redshaw 7 Schizophrenia Schizophrenia is a serious mental health condition. In men the condition usually begins between 15 and 30 years of age and in women, schizophrenia usually occurs later, beginning between 25 and 30 years of age. If you have schizophrenia, your brain works differently to other people's brains as it affects your thoughts, emotions and the way you behave. The exact cause of schizophrenia is unknown; however, most experts believe that the condition is caused by a combination of genetic and environmental factors. Specific content that will be addressed within this topic are: Schizophrenia Classification and • Clinical characteristics of schizophrenia diagnosis of • Issues surrounding the classification and diagnosis of Schizophrenia schizophrenia, including reliability and validity Explanations of • Biological explanations of schizophrenia, for Schizophrenia example, genetics, biochemistry • Psychological explanations of schizophrenia, for example, behavioural, cognitive and psychodynamic. Treatments for • Biological therapies for schizophrenia, including their Schizophrenia evaluation in terms of appropriateness and effectiveness • Psychological therapies for schizophrenia, for example, psychodynamic and cognitive-behavioural, including their evaluation in terms of appropriateness and effectiveness
  • 2. 8 The Independent Learner Series - Book 4 Classification and Diagnosis of Schizophrenia WEEK 1 Learning Objectives On completion of this unit you should be familiar with the following: 1. Clinical Characteristics of Schizophrenia 2. Issues surrounding the classification and diagnosis of schizophrenia, including reliability and validity The term schizophrenia, which means "split mind," comes from the Greek roots schizo (split) and phrene (mind). The term was first used in 1911 by Swiss psychiatrist Eugen Bleuler to categorise patients whose thought processes and emotional responses seemed disconnected. The symptoms of schizophrenia are complex and are often confused with other mental health conditions. The following sections will look at the clinical characteristics and the issues surrounding the diagnosis of schizophrenia. 1. Clinical Characteristics of Schizophrenia This section will focus on what DSM IV published by the American Psychiatric Association and ICD-10 published by the World Health Organisation, classify as schizophrenia. The signs and symptoms vary from individual to individual, but fall in to two distinct categories; positive and negative. Positive symptoms, which represent a change in behaviour or thoughts, include: • Delusions, which are an unshakable belief in something that is very unlikely, bizarre or obviously untrue. One of the delusions experienced in schizophrenia is paranoid delusions, where an individual believes that something, or someone, is deliberately trying to mislead, manipulate, hurt or, in some cases, even kill them. Another common delusion is the delusion of grandeur, which is where an individual believes that they have some imaginary power or authority, such as thinking that they are on a mission from God or that they are a secret agent. • Hallucinations, which usually take the form of hearing voices that are not there. These voices are normally critical and unfriendly. Additionally, some people with schizophrenia may also see, smell, taste and feel things that are not there. • Catatonic or disorganised behaviour, where an individual behaves in ways that seem inappropriate or strange to the norms of society. • Disorganised speech, often known as a ‘word salad’, where an individual speaks in ways that are completely incomprehensible. For instance, sentences might not make sense, or topic of conversation changes with little or no connection between sentences.
  • 3. Nick & Bethan Redshaw 9 Negative symptoms, which represent a lack of behaviour or thoughts, include: • A lack, or 'flattening', of emotions, where a person’s voice becomes dull and monotonous and their face takes on a constant blank appearance. • An inability to enjoy things that they used to enjoy. • Apathy, where they have a lack of motivation to follow through any plans and neglect household chores, such as washing the dishes or cleaning their clothes. • Social withdrawal, where they find it hard or become reluctant to speak to people. According to DSM IV all people diagnosed as suffering from schizophrenia must have one or more of the clinical characteristics outlined above present for at least 6 months or have produced a marked deterioration in ability to function adequately on a daily basis. However, if an individual is having extreme hallucinations, no other symptoms have to be present for them to be diagnosed as suffering from schizophrenia. Types of Schizophrenia To make the diagnosis and treatment of schizophrenia easier and more effective, psychiatrists and clinical psychologists have attempted to classify schizophrenia into different types. Disorganised Type Paranoid Type Catatonic Type TYPES OF SCHIZOPHRENIA Residual Type Undifferentiated Type These classifications are based on years of experience and research with symptoms and feelings described by patients and observations made by family members, nurses, doctors and psychiatrists.
  • 4. 10 The Independent Learner Series - Book 4 Activity 1 - Using the clinical characteristics outlined earlier in this section outline how a psychiatrist would diagnose a person suffering from paranoid schizophrenia. ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ (4 marks) Activity 2 - Using the clinical characteristics outlined earlier in this section outline how a psychiatrist would diagnose a person suffering from disorganised schizophrenia. ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ (4 marks) Activity 3 - Using the clinical characteristics outlined earlier in this section outline how a psychiatrist would diagnose a person suffering from catatonic schizophrenia. ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................ (4 marks) Activity 4 – You may have found activities 2 and 3 difficult to answer. Explain why. ................................................................................................................................................ ................................................................................................................................................ ................................................................................................................................................
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