Schizophrenia

Reference: Butcher, J. N., Hooley, J.S., & Mineka, S. (200 !. Schizophrenia an" #ther $%ychotic &i%or"er%. Abnormal Psychology, 12th ed. (p. '() **!. Ne+ Jer%ey: $ear%on ,"ucation, -nc.

Clinical Symptoms .haracterize" /y the pre%ence of %e0er "i%tur/ance% in thou1ht, /eha0iour, an" interper%onal relation%hip% Hall2ark i% a %i1nificant lo%% of contact +ith reality, often referre" to a% $%ycho%i% .linical Sy2pto2% &elu%ion% 3n erroneou% /elief that i% fi4e" an" fir2ly hel" "e%pite clear contra"ictory e0i"ence -n0ol0e% a "i%tur/ance in the content of thou1ht .o22on in %chizophrenic%, occurrin1 in 2ore than 506 of patient% at a ti2e Hallucination% 3 %en%ory e4perience that occur% in the a/%ence of any e4ternal perceptual %ti2ulu% .an occur in any %en%ory 2o"ality &i%or1anize" Speech ,4ternal 2anife%tation of a "i%or"er in thou1ht for2 3ffecte" per%on fail% to 2ake %en%e "e%pite %ee2in1 to confor2 to the %e2antic an" %yntactic rule% 1o0ernin1 0er/al co22unication 7or"% an" co2/ination% %oun"% co22unicati0e /ut fail% to 1et the 2e%%a1e acro%% Neolo1i%2% 8 co2pletely ne+, 2a"e)up +or"% %o2eti2e% appear in a patient9% %peech I have also "killed" my ex-wife in a 2. to !." ho#rs sex bo#t in $evon Pennsylvania in 1%&', while two Pitcairns were reading in my next room closet, hearing the event. (nclosed, )lease find my #rology re)ort, indicating that my male genitals, s)ecifically my )enis, are within normal si*e and that I+m ca)able or normal interco#rse with any woman, signed by $r. ,name-, a #rologist and s#rgeon who )erformed a circ#mcision on me in 1%.2. /oncl#sion0 I cannot be a

nincom)oo) in a )hysical sense 1#nless 2ociety wo#ld feed me chemicals for my )ict#re in the nincom)oo) book3. &i%or1anize" an" .atatonic Beha0iour :oal)oriente" acti0ity i% uni0er%ally "i%rupte" -2pair2ent occur% in area% of routine "aily functionin1 .atatonia in0ol0e% the total a/%ence of all 2o0e2ent an" %peech +here the patient can /e in +hat i% calle" a ;catatonic %tupor< 3 patient 2ay al%o hol" an unu%ual po%ition for an e4ten"e" perio" of ti2e +ithout any %ee2in1 "i%co2fort Schizophrenia i% an epi%o"ic "i%or"er +ith three "i%tinct pha%e% $ro"ro2al pha%e Si1nificant "eterioration of %ocial an" co1niti0e functionin1 fro2 a pre2or/i" le0el 7ith"ra+al fro2 %ocial %ituation%, ne1lect of "utie% an" hy1iene, %tran1e thou1ht% an" e2otion%, lo%% of ener1y an" initiati0e 3cti0e pha%e Marke"ly p%ychotic /eha0iour% e2er1e: "elu%ion%, hallucination%, "i%or1anize" thou1ht pattern%, o"" %peech, incoherence, inappropriate or re%tricte" e2otional reaction% Re%i"ual pha%e Sy2pto2% %i2ilar to tho%e in pro"ro2al pha%e +ith the e4ception of e2otional /luntin1 an" particularly pronounce" ne1lect for one9% "utie%

Five Subtypes of Schizophrenia .atatonic Schizophrenia Se0ere "i%tur/ance% in p%ycho2otor /eha0iour $atient% are fre=uently 2ute an" unre%pon%i0e $atient% 2ay a%%u2e ri1i", pa%%i0e, or /izarre po%ture%

 >nifyin1 =uality of catatonic%: al2o%t co2pletely unre%pon%i0e to their en0iron2ent So2e of the%e patient% are hi1hly %u11e%ti/le an" +ill auto2atically o/ey co22an"% or i2itate the action% of other% (echopra4ia! or 2i2ic their phra%e% (echolalia! May pa%% %u""enly fro2 e4tre2e %tupor to a %tate of 1reat e4cite2ent, "urin1 +hich they 2ay %ee2 to /e un"er ?1reat pre%%ure of acti0ity? an" 2ay /eco2e 0iolent &i%or1anize" Schizophrenia $atient% e4hi/it %tran1e, incoherent, an" often %illy /eha0iour :ro%% "i%tur/ance% in thou1ht proce%%e% 0er%u% their p%ycho2otor proce%%e% Speech i% characterize" /y loo%e a%%ociation%, neolo1i%2%, an" clan1in1 3ppear to /e %o2e+hat re%pon%i0e to the en0iro2ent, re%pon%e% ho+e0er 2ay /e inco2prehen%i/le an" unpre"icta/le >%ually occur% at an earlier a1e an" ha% a 1ra"ual, in%i"iou% on%et $er%on 1ra"ually /eco2e% 2ore reclu%i0e an" preoccupie" +ith fanta%ie% $aranoi" Schizophrenia $reoccupation +ith ela/orate "elu%ional %y%te2%, u%ually relatin1 to the2e% of 1ran"io%ity, per%ecution, @ealou%y, an"Aor %u%piciou%ne%% .a%t of "elu%ional %y%te2% typically in0ol0e% "i0ine or %upernatural /ein1%, i2portant people in the patient9% life, or i2a1e% fro2 hi%tory or the 2e"ia >%ually appear to act fairly nor2ally, at lea%t in the %uperficial le0el, unle%% they are in the proce%% of actin1 on their "elu%ion% ,0entual clinical picture i% "o2inate" /y a/%ur" an" illo1ical i"ea% an" /elief% that are often hi1hly ela/orate" an" or1anize" into a coherent, thou1h "elu%ional, fra2e+ork >n"ifferentiate" Schizophrenia ,ither "i%play pro2inent p%ychotic %y2pto2% fro2 2ore than one of the a/o0e cate1orie% or %ho+ %y2pto2% that "o not fit ea%ily into any of the a/o0e cate1orie% Bhe ;1ar/a1e can< la/el

 Re%i"ual Schizophrenia $eople +ho ha0e %uffere" fro2 at lea%t one epi%o"e of %chizophrenia /ut "o not no+ %ho+ any pro2inent %y2pto2% %uch a% hallucination%, "elu%ion%, or "i%or1anize" %peech or /eha0ior ,4hi/it relati0ely 2il" %i1n% of %chizophrenia $atient9% life taken a% a +hole 1enerally lack% 2eanin1 an" coherence +ith a %e0ere "eficit in 2any of the hi1her)or"er a/ilitie% Considerations and Recommendations Schizophrenia con%titute% a "i0er%e cla%% of "i%or"er% that pro1re%% throu1h "i%tinct pha%e% an" 2anife%t in a 0ariety of +ay% .a%e% %ho+ 1reat in"i0i"ual "ifference% in /eha0iour pattern% 2akin1 it 0ery "ifficult, if not i2po%%i/le, to pre"ict +hen a patient +ill enter an acti0e pha%e 3/out C6 of the population +ill %uffer %o2e for2 of %chizophrenia "urin1 their lifeti2e% $u/lic perception i% /a%e" al2o%t e4clu%i0ely on the p%ychotic %y2pto2% e2er1in1 in the acti0e pha%e .on%i"eration% an" Reco22en"ation% -t i% clear that %chizophrenia ha% a 1enetic co2ponent /ut little i% kno+n a/out the cau%e% of the "i%or"er N# .>R,: treat2ent i% pri2arily throu1h the a"2ini%tration of antip%ychotic 2e"ication +ith the 1oal of "ecrea%in1 p%ychotic %y2pto2% an" controllin1 re%i"ual %y2pto2% to the point +here the patient can function in a 2ore 2ana1ea/le an" pro"ucti0e le0el &o%a1e of 2e"ication "epen"% on the patient9% nee"% Bhe ;re0ol0in1 "oor %yn"ro2e<: cycle of treat2ent an" "eco2pen%ation .on%i"eration% an" Reco22en"ation% #n the occa%ion that a patient "oe% not %ho+ any re%i"ual %i1n% follo+in1 the a/ate2ent of p%ychotic %y2pto2%, he or %he 2ay /e +ith"ra+n fro2 2e"ication entirely, /ut it i% po%%i/le that the per%on %uffer% fro2 another "i%or"er +ith p%ychotic feature% Bherapi%t% 2u%t /e +ary of the po%%i/le %i"e effect% of 2e"ication, particularly a con"ition kno+n a% tar"i0e "y%ken%ia +here a per%on9% 2otor 2o0e2ent% are i2paire" an" %hakine%% i% e4perience" "ue to prolon1e" phar2acolo1ical treat2ent