Schizophrenia

Question 1

Define schizophrenia

Answer 1

• a severe type of psychotic disorder
• the disintegration of the process of thinking & of emotional responsiveness

Question 2

Describe the prevalence and age of onset of schizophrenia

Answer 2

• Prevalence is similar in both males and females (about 0.3-0.7%)
• Age of onset is typically earlier in males (early-to-mid 20s) compared to females (late 20s)
• Late onset (40 onwards) more common im females
• Children aged 13 and under rarely diagnosed with schizophrenia, as their symptoms can overlap with other conditions (e.g. OCD and autism), therefore diagnosis unreliable and difficult
• However, sometimes symptoms in children can be obvious as seen in Aneja et al.

Question 3

In ICD-11, define ‘positive symptoms’ in schizophrenia. Outline these symptoms and what they mean.

Answer 3

• symptoms in addition to normal behaviour/distortion of normal behaviour

Positive symptoms:

1. Persistent delusions: beliefs an individual holds that aren’t based on reality
2. Persistent hallucinations: sensory experiences someone may have. Can be auditory (hearing voices) or visual (seeing things that aren’t there)
3. Thought disorder: inability to think and speak in organised manner
4. Experiences of influence, passivity and control: beliefs that one’s thoughts/behaviours/experiences are influenced/controlled by someone or something external

Question 4

In ICD-11, define ‘negative symptoms’ in schizophrenia. Outline these symptoms and what they mean.

Answer 4

• symptoms that cause levels of functioning to fall below normal

Negative symptoms:

1. Avolition: lack of motivation
2. Flattened effect: lack of expression/emotion (smiling, frowning)
3. Impaired cognitive function: reduced memory or attention
4. Catatonia: lack of speech/movement, where individuals often find themselves stuck in rigid positions

Question 5

How can a person be diagnosed with schizophrenia?

Answer 5

• at least 1 of the core symptoms must be experienced for at least 1 month
• not due to medical conditions (e.g. brain tumour), substance abuse or medication
• in less clear cut cases, 2 core symptoms must be identified
• all other causes of symptoms must be eliminated

Question 6

What is the case history of the 14-year old boy in Aneja et al.?

Answer 6

• boy came from a troubled home with an abusive father
• at 10, parents divorced, he began living with his grandparents
• schoolwork suffered, and by 12, he stopped attending school
• sad, irritable, often got in trouble for fighting

Question 7

What were the symptoms of the boy in Aneja et al.?

Answer 7

• at 12, began hearing voices, and believed mother among other people were communicating with the voices
• suspicious of his mother
• spoke very little
• muttered, laughed, shouted at unseen others

Question 8

What was the treatment of the boy in Aneja et al.?

Answer 8

• given sodium valporate (drug used to treat bipolar
• mood and behaviour improved, but soon got worse
• eventually diagnosed with early-onset schizophrenia
• aggressive and violent outbursts increased, often admitted to hospital for own safety
• released from hospital once behaviour regulated thru medication
• but negative symptoms still persisted (apathy, social withdrawal, resistance from going to school)

Question 9

What are the strengths of Aneja et al.?