Schizophrenia history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2], Irfan Dotani

## Overview[edit | edit source]

A person experiencing schizophrenia may demonstrate symptoms such as disorganized thinking, auditory hallucinations, and delusions. The current classification of psychoses holds that symptoms need to have been present for at least one month in a period of at least six months of disturbed functioning. Social isolation commonly occurs.

## History and Symptoms[edit | edit source]

* A person experiencing schizophrenia may demonstrate symptoms such as disorganized thinking, auditory hallucinations, and delusions.
* In severe cases, the person may be largely mute, remain motionless in bizarre postures, or exhibit purposeless agitation; these are signs of catatonia.
* The current classification of psychoses holds that symptoms need to have been present for at least one month in a period of at least six months of disturbed functioning.
* A schizophrenia-like psychosis of shorter duration is termed a schizophreniform disorder.[1]
* No one sign is diagnostic of schizophrenia, and all can occur in other medical and psychiatric conditions.[1]

* Social isolation commonly occurs and may be due to a number of factors.
* Impairment in social cognition is associated with schizophrenia, as are the active symptoms of paranoia from delusions and hallucinations, and the negative symptoms of apathy and avolition.
* Many people diagnosed with schizophrenia avoid potentially stressful social situations that may exacerbate mental distress.[2]

* Late adolescence and early adulthood are peak years for the onset of schizophrenia.
* These are critical periods in a young adult's social and vocational development, and they can be severely disrupted by disease onset.
* To minimize the impact of schizophrenia, much work has recently been done to identify and treat the prodromal (pre-onset) phase of the illness, which has been detected up to 30 months before the onset of symptoms, but may be present longer.[3]
* Those who go on to develop schizophrenia may experience the non-specific symptoms of social withdrawal, irritability and dysphoria in the prodromal period, and transient or self-limiting psychotic symptoms in the prodromal phase before psychosis becomes apparent.[4][5]

### Positive and Negative Symptoms[edit | edit source]

* Schizophrenia is often described in terms of positive (or productive) and negative (or deficit) symptoms.[6]
* Positive symptoms include delusions, auditory hallucinations, and thought disorder, and are typically regarded as manifestations of psychosis.
* Negative symptoms are so-named because they are considered to be the loss or absence of normal traits or abilities, and include features such as flat or blunted affect and emotion, poverty of speech (alogia), anhedonia, and lack of motivation (avolition).
* Despite the appearance of blunted affect, recent studies indicate that there is often a normal or even heightened level of emotionality in Schizophrenia especially in response to stressful or negative events.[7]
* A third symptom grouping, the disorganization syndrome, is commonly described, and includes chaotic speech, thought, and behaviour.
* There is evidence for a number of other symptom classifications.[8]

## References[edit | edit source]

1. ↑ 1.0 1.1 American Psychiatric Association (2004) Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (Text Revision). American Psychiatric Association. ISBN 0890420246. DSM-IV & DSM-IV-TR Schizophrenia criteria
2. ↑ Freeman D, Garety PA, Kuipers E, Fowler D, Bebbington PE, Dunn G. (2007) Acting on persecutory delusions: the importance of safety seeking. Behaviour Research and Therapy, 45 (1), 89–99. PMID 16530161
3. ↑ Addington J, Cadenhead KS, Cannon TD, Cornblatt B, McGlashan TH, Perkins DO, Seidman LJ, Tsuang M, Walker EF, Woods SW, Heinssen R. (2007) North American prodrome longitudinal study: a collaborative multisite approach to prodromal schizophrenia research. Schizophrenia Bulletin, 33 (3), 665-72. PMID 17255119
4. ↑ Parnas J, Jorgensen A. (1989) Pre-morbid psychopathology in schizophrenia spectrum. British Journal of Psychiatry, 155, 623–7.
5. ↑ Amminger GP, Leicester S, Yung AR, Phillips LJ, Berger GE, Francey SM, Yuen HP, McGorry PD. (2006) Early-onset of symptoms predicts conversion to non-affective psychosis in ultra-high risk individuals. Schizophrenia Research, 84 (1), 67–76. PMID 16677803
6. ↑ Sims A (2002) Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd edition). Edinburgh: Elsevier Science Ltd. ISBN 0-7020-2627-1
7. ↑ Cohen & Docherty (2004). Affective reactivity of speech and emotional experience in patients with schizophrenia. Schizophr Res, 1;69(1):7–14. PMID 15145465
8. ↑ Peralta V, Cuesta MJ. (2001) How many and which are the psychopathological dimensions in schizophrenia? Issues influencing their ascertainment. Schizophrenia Research, 30, 49(3), 269-85. PMID 11356588

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