PYA5 – PSYCHOPATHOLOGY – REVISION SUMMARY
Clinical Characteristics
Schizophrenia
Physical/behavioural:
→ Psychomotor poverty,
catatonia – awkward postures
assumed, remain motionless in
this position for hours
→ ‘Waxy flexibility’ – body can be
manipulated into different
positions
→ Catatonic stupor – lie
motionless, unware of
surroundings but fully conscious
→ Or increased motor activity –
e.g. purposeless & repetitive
movement
→ Disorganised/chaotic/bizarre
behaviour can be linked to
other symptoms e.g. cover
windows with black paper ->
cognitive disturbance.
Perceptual:
→ Auditory hallucinations – most
common – abusive voices,
critical running commentary on
behaviour
→ Visual, smell & taste
hallucinations too, but less
common
Cognitive:
→ Delusions
 of grandeur
 persecutory
 paranoia
 ‘alien control symptoms’
(belief behaviour’s under external
control)
 these all develop into
complex web of delusion
→ Thought interference
symptoms
 thought insertion
 thought withdrawal (belief
thoughts are being extracted from
mind)
 broadcasting (belief ppl can ‘tune
in’ to your thoughts)
→ Cognitive impairments
intellectual deficits in learning
Depression
Physical/behavioural:
→ Changes in appetite – tends to
be reduced but can increase
(comfort eating). Generally
unhealthy though.
→ Sleep disturbances – most
common is insomnia but also
hypersomnia which is excessive
sleeping, most likely to escape
reality
→ Lethargy & tiredness (due to
sleep disturbance?) or
restlessness
→ Sex drive usually reduced
→ Apathy – in appearance, work,
home, others. Reduced activity
due to lack of interest and
energy.
Perceptual:
→ Auditory hallucinations may
occur – extreme forms of self-
critical delusions
Cognitive:
→ Slow, muddled thinking –>
difficulty in making decisions
→ Pessimistic/negative thinking,
suicidal in severe cases
→ Negative self-concept = faulty
thinking -> individual overly
critical of him/herself – can
develop into delusions.
Anxiety Disorders
Physical/behavioural:
→ Immediate physical symptoms
are the body’s response to
stress
→ But it is heightened – can result
in breathlessness, tightness in
the chest, hyperventilation,
palpitations
→ Hyperventilation increases CO2
, leading to light-headedness,
‘pins and needles’ & even
painful muscle contractions
→ Muscle tension -> headaches,
aching, stiffness, particularly in
back, neck, shoulders
→ Avoidance behaviour shown –
avoiding feared object –
sometimes greatly restricting
everyday behaviour
→ Restless, ‘jumpy’ behaviour –
difficulty in relaxing – startle
response is often common
Cognitive:
→ Anxiety can decrease
concentration – decrease ability
to perform complex tasks
→ Reduced cognitive capacity can
inhibit workplace functioning
PYA5 – PSYCHOPATHOLOGY – REVISION SUMMARY

& memory
→ Language impairments
 neologisms (inventing words)
 echololia (repeating sounds)
 word salad (jumbled speech)
 clang associations (nonsensical
rhyming)
 incoherent & abrupt topic
changes due to cognitive
distractibility (inability to
maintain train of thought)
Social: Social: Social:
→ social withdrawal is usual → Social withdrawal – no pleasure → Anxiety may reduce ability to
→ may always have lacked social from social interaction – feel cope w/ social settings,
skills they have nothing valuable to inhibiting personal and social
→ little interest in social contribute – do not want others functioning
interactions – no pleasure from to witness their depressed
them state.
→ may appear aloof, reclusive &
emotionally distant even before
onset of schiz.
Emotional: Emotional: Emotional:
→ emotional blunting (lack of → Low mood, unhappiness, → Feeling of dread
emotion) anguish, often on verge of tears
→ inappropriate affect e.g. → May experience anhedonia – → Individual is frightened &
laughing when told someone’s loss of pleasure in activities distressed
died previously enjoyed
→ 1/3 of schiz. patients suffer → Diurnal mood variations may → May feel they’re about to die
depressive symptoms occur – mood changes or lose control of bodily
→ 1/8 meet the criteria for a throughout the day, being functions!
mood disorder as well as particularly low in the morning
schiz., therefore tend to be but improving a little as day
diagnosed with schizo-affective progresses.
disorder
→ Apathy & lack of drive,
interest, personal care,
hygiene – all are common & can
be linked to depressed state

Types & Diagnosis

Schizophrenia Depression Anxiety Disorders
→ DSM-IV identifies 5 types of → Depression is the main Phobias
schizophrenia: symptom of a range of mood → Main categories of phobias are:
disorders, including: specific phobia, social phobia
 Disorganised and agoraphobia.
 Catatonic  Unipolar (major depression)
 Paranoid  Bipolar (manic depression) → Specific phobia (prevalence: 4-
 Undifferentiated 7% of pop.) – phobia of specific
 Premenstrual syndrome
 Residual object – five types:
(PMS)
 Postpartum depression (PPD)
→ But a more recent typology is  Seasonal affective disorder  animal
Liddle’s core symptoms of (SAD)  environmental danger
schizophrenia:  blood-injection-injury,
Reality distortion:  situational (planes, lifts,
 Hallucinations → Major depression can be
divided into two different enclosed spaces)
 Delusions  ‘other’
PYA5 – PSYCHOPATHOLOGY – REVISION SUMMARY
 Thought interference
Disorganisation:
 Thought disorder
 Language disturbances
 Psychomotor disturbances
 Inappropriate affect
Poverty:
 Lack of emotion
 Apathy, lack of motivation
 Cognitive impairments
 Psychomotor poverty
 Social withdrawal
→ Another way of classifying is by
positive (Type 1) and negative
symptoms (Type 2):
 Positive: hallucinations,
delusions, thought disturbances
 Negative: lack of interest,
emotion, motivation and social
withdrawal
 But schizophrenia is an episodic
illness usually, consisting of
periods of acute positive
symptoms interspersed with
periods of better functioning
(negative symptoms), and schiz
patients may show both, which
contradicts this reductionist
typology.
 But it is true that the acute
phrase tends to resemble Type
1 and the chronic phase often
resembles Type 2.
→ DSM-IV diagnostic critera:
 2 or more symptoms identified
above for a period of 1 month+.
One symptom only is needed if
delusions are bizarre or if the
hallucination is critical/abusive
of their behaviour
 Disturbance must be evident over
significant period of time, 6
months+, including 1 month of
pronounced symptoms
 Symptoms must have led to a
failure to function in social &
occupational roles
types:
 Endogenous – caused by
factors within the sufferer
 Reactive – caused by external
factors e.g. stressful life
events; this is the most
common type
 However, it is important to be
wary of this distinction
because the depression may
be due to internal AND
external factors
 A distinction is often made
between minor, neurotic
illness and major, psychotic
illness; the former is mood
disturbance only, & latter
when there are severe
cognitive & perceptual
distortions e.g. delusions,
hallucinations
 Dysthymia is a type of
depression that persists over
months or years – less severe
though.
 Major depression tends to be
episodic
→ DSM-IV: diagnosis of depression
requires 5 of the physical,
perceptual, behavioural,
cognitive, social and emotional
symptoms to persist over 2
weeks+
→ Social phobia (prevalence: 1-2%
of pop.) – fear of social
situations due to self-
consciousness of behaviour &
fear of others reactions; can be
generalised (most situations) or
specific (e.g. public speaking)
→ Agoraphobia (prevalence: 2-3%
of population) – fear of
open/public places, public
transport, crowds etc. – very
rare on its own as it is co-
morbid with panic disorder.
Panic disorder tends to occur
first, then individual avoids
public places to avoid panic
attack, thus agoraphobia
develops.
→ DSM-IV diagnostic criteria:
 Marked and persistent fear
of a specific object or
situation
 Exposure to fear-provoking
stimulus produces rapid
anxiety response
 Individual recognises the fear
experienced is excessive
 Phobic stimulus is either
avoided or responded to
with great anxiety
 Phobic reactions interfere
significantly with individual’s
working or social life/there is
marked distress about the
phobia
PYA5 – PSYCHOPATHOLOGY – REVISION SUMMARY