Bleuler

1911

Described general disorders linked with a split in the 'psyche'

Main Symptoms

Auditory - hallucinations, hearing voices

Delusions - false beliefs; grandeur/perception

Disordered thinking - thoughts inserted or withdrawn from mind

Control - lack of self control

Emotional/Volitional changes - 'flat' emotions, little energy

Wing

1992

Argued a distinction between primary and secondary impairments.

Primary Impairments

Hallucinations

Delusions

Thought disorders

Apathy

Emotional blunting

Secondary Impairments

Social:                                                        Psychological:

Unemployment                                             Dependent

Social drift                                                 Poor coping

Institutlionalisation                                     Loss of confidence

Rejection                                                    No motivation

Prejudice

Andreason

1995

Identified two general patterns of symotoms evident in schizophrenia.

Positive syndrome schizophrenia

and

Negative syndrome schizophrenia

Positive Symptoms

Additional to normal behaviour/experience

Hallucinations/delusions

Resopnise to drug treatment

Limbic system abnormalities

Negative Symptoms

Deficit in normal behaviour patterns

Lack of communication/emotional expression

Less responsive to drugs

Abnormalities in the frontal lobes

Enlarged ventricles

DSM IV

A Characteristic symptoms: 2+ present for 1month: hallucinations, disorganised speech, disoganised/catatonic behaviour, negative symptoms.

B Social/occupational dysfunction: Significant portion of time since onset, 1+ major area of functioning, e.g. work, self care, markedly below level achieved prior to onset.

C Duration: Continuous signs of disturbance for at least 6months. At least 1month (less if treated) that meet A.

Types of Schizophrenia

Paranoid: 1+ delusions/auditory hallucinations.

Catatonic: 2+ immobility/stupor, negativism/mutism, stereotyped movements, grimacing, echolalia/echopraxia.

Disorganised: All present - disorganised speech/behaviour, flat effect.

Undifferentiated: Only characteristic symptoms present.

Residual: Absence of other symptoms. Negative symptoms present or 2+ characteristic symptoms in attenuated form.