Chapter 1
Chapter 1
Definition: Schizophrenia is a heterogenous clinical syndrome that involves a constellation of signs and symptoms.
- Characterised by delusions, hallucinations, disorganized speech (e.g., frequent derailment or incoherence), grossly disorganized or catatonic behavior and negative symptoms (i.e., diminished emotional expression or avolition).
History
History
Emil Kraepelin gave two clinical types: Dementia praecox, and Manic depressive illness. He described Dementia Praecox as a loss of the inner unity of the activities of intellect, emotion, and volition; and stated that it has an early onset and deteriorating coarse.
In 1911, the term schizophrenia, was introduced by Eugen Bleuler. He proposed the name to denote a "splitting" of psychic functions, which he considered to be the core feature of the illness. Unlike Kreplin he stated that the disease need not always have a poor prognosis. He gave four primary symptoms ("the Four As") were abnormal associations, autistic behavior and thinking, abnormal affect, and ambivalence. He considered hallucinations, delusions, social withdrawal, and diminished drive as secondary manifestations of the illness ((Kaplan & Sadock, 1994 CTP).
Kurt Schneider gave the "first-rank symptoms".
One. Audible thoughts: Auditory hallucinations of a person's thoughts being spoken aloud.
Two. Voices arguing or discussing: Auditory hallucinations of two or more voices arguing or discussing, usually about the person experiencing the hallucination.
Three. Voices commenting on patient's actions: Auditory hallucinations commenting on a person's behaviors.
Four. Somatic passivity: Tactile or visceral hallucinations that are imposed by some external agent; can be combinations of different somatic hallucinations.
Five. Thought withdrawal: Sensation of thoughts being actively removed from a person's mind.
Six. Thought insertion: Thoughts inserted into a person's mind by some external agent.
Seven. Thought broadcasting: The sense that a person's thoughts are experienced as real phenomena by others- the thoughts are made audible, or may be experienced by others through telepathy.
Eight. Made feelings: Feelings that are not a person's own are imposed on that person by an external agent.
Nine. Made impulses or drives: An impulse for action is imposed on a person by some external agent.
Ten. Made volitional acts: A person's actions are from and are controlled by an external agent; the person is a passive participant in the action.
Eleven. Delusional perception: A perception that has a unique and idiosyncratic meaning for a person, which leads to an immediate delusional interpretation.