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chizophrenia is a mental health
condition associated with unusual expressions or perceptions of reality. It can
lead to significant social or occupational dysfunction.
It
can feature auditory hallucinations, or hearing things that are not there. Less
commonly, the person may experience visual hallucinations, in which they see
things that do not exist.
There may be bizarre or paranoid delusions, and
disorganized speech and thinking.
Schizophrenia is normally diagnosed in
early adulthood. The United States (U.S.) Centers for Disease Control and
Prevention (CDC), estimate that schizophrenia affects between between 0.6 and 1 percent of
the global population.
Classification and diagnosis
Schizophrenia is a serious
mental health issue.
In the past, there were different subtypes of
schizophrenia, including:
·
disorganized,
or hebephrenic schizophrenia
In 2013 the Diagnostic and
Statistical Manual of Mental Disorders 5th edition (DSM-V) changed the method
of classification to bring all these categories under a single heading:
schizophrenia.
According to the American Psychiatric Association
(APA), the decision to eliminate these various subtypes was based on the conclusion they
had "limited diagnostic stability, low reliability, and poor
validity." It was concluded that they did not help to provide better
treatment or to predict how patients would respond to treatment.
Two other important changes were made to the diagnostic
criteria in 2013.
One was the removal of the requirement for a person to
experience bizarre delusions and to hear two or more voices talking during an
auditory hallucination to receive a positive diagnosis.
The second was that, to receive a diagnosis, a person must have at least one of
the following symptoms:
·
hallucinations
·
delusions
·
disorganized
speech
Click here for a more comprehensive
article on schizophrenia.
Subtypes
The following used to be subtypes of schizophrenia.
Find out what has changed in the use of these categories.
Schizoaffective
Disorder
A person with schizoaffective disorder experiences a
combination of schizophrenia symptoms, such as hallucinations and delusions,
and mood disorder symptoms, such as mania or depression.
In the past, the person had to have both sets of
symptoms at the same time to receive a diagnosis of schizoaffective disorder.
The DSM-V update in 2013 now says that to be
diagnosed with schizoaffective disorder, a person must have experienced mood
disorders for most of the time they have also had the psychotic symptoms of
schizophrenia, from when they first started having symptoms up to the present.
Catatonia
Catatonia includes extremes of behavior:
·
Catatonia
can include excessive and peculiar motor behaviors, sometimes referred to as
catatonic excitement
·
Catatonia
can also include decreased motor activity and engagement. For example, people
in a catatonic stupor demonstrate a dramatic reduction in activity, where the
patient cannot speak, move or respond. Virtually all movements stop.
Catatonia can occur with schizophrenia and a range of
other conditions including bipolar disorder. For this reason, it is now
considered a specifier for
schizophrenia and other mood disorders, rather than a type of schizophrenia.
Childhood onset
schizophrenia
The symptoms of schizophrenia normally appear during
early adulthood, but they can sometimes emerge during childhood, at the age of
10 years or earlier. It is extremely rare, with an incidence of less than 0.04 percent.
If schizophrenia occurs in a child, it is very serious,
and treatment is needed.
However, healthy children can experience
hallucinations, so if this happens, it does not mean that a child has
schizophrenia.
Disorganized schizophrenia, or hebephrenia
Disorganized thinking and behavior are features of
schizophrenia. The person may have incoherent and illogical thoughts and
speech.
This can make it difficult to perform daily activities,
such as preparing meals and taking care of personal hygiene, or washing. People
may not be able to understand what the patient is saying. This can lead to
frustration and agitation.
While disorganization is a feature of schizophrenia, it
is no longer considered a separate subtype.
Paranoid
Schizophrenia
A person with schizophrenia may have
false beliefs, or delusions, that an individual or group of people are
conspiring to harm them or members of their family. They may spend time
thinking about ways to protect themselves from the people they believe are
persecuting them.
While
delusions can still be key to a diagnosis of schizophrenia, this is no longer
considered a separate subtype of the disorder.
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