Schizophrenia

If you ask a mental health professional which disorder has the most profound consequences for an individual, most would likely respond, 'Schizophrenia.' Let's try to understand why.

In Schizophrenia, it is possible to define two categories of psychotic symptoms:

• Positive symptoms: delusions, hallucinations, disorganized thinking, disorganized motor behavior
• Negative symptoms: anhedonia, abulia, alogia, asociality, emotional flattening.

Positive symptoms take individuals away from reality, and negative symptoms distance them from social life. Therefore, the quality of life is seriously compromised.

Moreover, these individuals may not be aware that something is wrong with them, a characteristic known as anosognosia. This can lead to compulsory treatments and aggression. Note that I didn't say aggression is a typical trait of schizophrenia; on the contrary, most individuals are not aggressive and are more frequently victims of abuse.

Additionally, there may be a series of associated issues, such as:

- Emotional reactions unrelated to the situation - Strong emotional experiences - Disturbed sleep-wake cycle - Lack of interest in food or sex - Impairments in coordination - Problems in perception, attention, and memory.

If we want to clinically define Schizophrenia, the diagnostic manual outlines the following criteria: A. At least two psychotic symptoms (one of which must be positive) for no less than one month. B. A significantly lower level of social and occupational functioning than before the onset of symptoms. C. Global signs of the disorder persist for at least six months. D, E, F. Define exclusion conditions.

The diagnostic manual adds Schizophreniform Disorder and Schizoaffective Disorder to Schizophrenia.

Schizophreniform Disorder differs from Schizophrenia because the signs of the disorder last for at least one month but less than six months. Schizoaffective Disorder is characterized by a complex combination of symptoms of Schizophrenia and mood disorders such as mania and depression (which I will discuss in a different post).

Sources:
- American Psychiatric Association (2013) - Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
- Bernhill, J. W. (2014) - DSM-5 Clinical Cases.

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