Psychosis: a lack of contact with reality, experiencing reality in a different way than other
people do. DSM defines psychosis in terms of symptoms. Less than 1% has schizophrenia.
Positive symptoms of schizophrenia: add to reality
delusion: believing in weird conspiracy things, a concept or belief that doesn’t correspond to
reality, a really fixed belief that is not able to change even with conflicting evidence.
persecutory delusion: believing people are out there to get you, thinking people are
spying on you, being scared you will be mistreated or harassed.
referential delusion: believing that things are aimed at you while they are not, like
thinking people on tv looking into the camera are really talking to you.
hallucination: a sensory perception-like experience without an external stimulus
receiving a trigger, having an intrusive thought, misinterpreting the inner thought as
an inner voice, this is a hallucination.
most common is hearing voices
can occur in all modalities
5 – 28% of general population has audiovisual hallucinations
50% of kids ranging from 5-12 years old has imaginary friends
Negative symptoms of schizophrenia: missing things from normal reality
alogia: reduced speech production.
anhedonia: loss of interest or pleasure.
avolition: lack of motivation and no interest in routine activities like going to school/work.
asociality: severe impairments in social relationships and very little interest in being with
other people.
blunted affect: lack of outward expression of emotion.
Disorganized speech, motor agitation and catatonic behaviour.
Anosognosia: reduced insight into the illness. A psychotic patient has to be anosognostic in
order to have a psychosis, otherwise the patient wouldn’t believe his delusions and
hallucinations.
- negative symptoms have a stronger genetic component than positive symptoms.
- schizophrenic patients have larger ventricles in their brain and other anomalies, possible
because of a viral infection during the pregnancy or a difficult birth.
- the severity of schizophrenia is measured with semi-structured interviews and using scales
like for example the Positive and Negative Syndrome Scale.
- dealing with migration / urbanization / poverty increase risk of schizophrenia.
- being deaf impedes the development of mentalising and thus higher risk of psychosis.
Schizoaffective disorder: an uninterrupted period of illness during which there is a major
mood episode (either manic or depressive) concurrent with the basic symptoms of
schizophrenia.
, How disorders differentiate from schizophrenia:
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