Chapter 14
Schizophrenia, Schizotypal and
Delusional Disorders
81
, Chapter 14: Schizophrenia, Schizotypal and Delusional
Disorders
Introduction
• Schizophrenia is a major psychiatric disorder, or cluster of disorders, characterised by psychotic symptoms
that alter a person’s perception, thoughts, affect and behaviour.
• Each person with the disorder will have a unique combination of symptoms and experiences.
• Typically there is a prodromal period often characterised by some deterioration in personal functioning. This
includes memory and concentration problems, unusual behaviour and ideas, disturbed communication and
affect, social withdrawal, apathy and reduced interest in daily activities. These are sometimes called ‘negative
symptoms’.
• The prodromal period is usually followed by an acute episode marked by hallucinations, delusions, and
behavioural disturbances. These are sometimes called ‘positive symptoms’ and are usually accompanied by
agitation and distress.
• Following resolution of the acute episode, usually after biological, psychological and other interventions,
symptoms diminish and often disappear for many people, although sometimes a number of negative
symptoms may remain. This phase, which can last for many years, may be interrupted by recurrent acute
episodes, which may need additional intervention.
• A significant number of people continue to experience long-term impairments and as a result, schizophrenia
can have a considerable effect on people’s personal, social and occupational lives.
• The disabilities experienced by people with schizophrenia are not solely the result of recurrent episodes or
continuing symptoms. Unpleasant side effects of treatment, social adversity and isolation, poverty and
homelessness also play a part.
ICD-10 classification
1. Schizophrenia
A. Paranoid schizophrenia.
B. Hebephrenic schizophrenia.
C. Catatonic schizophrenia.
D. Undifferentiated schizophrenia.
E. Post-schizophrenic depression.
F. Residual schizophrenia.
G. Simple schizophrenia.
2. Schizotypal disorder
3. Persistent delusional disorders
A. Delusional disorder.
B. Other persistent delusional disorders.
4. Acute and transient psychotic disorders
A. Acute polymorphic psychotic disorder without symptoms of schizophrenia.
B. Acute polymorphic psychotic disorder with symptoms of schizophrenia.
C. Acute schizophrenia-like psychotic disorder.
D. Other acute predominantly delusional psychotic disorder.
5. Induced delusional disorder
6. Schizoaffective disorders
A. Schizoaffective disorder, manic type.
B. Schizoaffective disorder, depressive type.
C. Schizoaffective disorder, mixed type.
1. Schizophrenia
ICD-10 criteria
• A minimum of one of the symptoms listed under (1) below, or at least two of the symptoms listed under (2),
should be present for most of the time during a period of one month or more.
• Conditions meeting such symptomatic requirements but of duration less than one month (whether treated or not)
should be diagnosed as acute schizophrenic-like psychotic disorder and reclassified as schizophrenia if the
symptoms persist for longer periods.
(1). At least one of the following must be present:
A. Thought insertion, withdrawal, echo or broadcasting.
B. Delusions of control, influence or passivity, clearly referred to body or limb movements or specific
thoughts, actions, or sensations; delusional perception. Hallucinatory voices giving a running commentary on
the patient’s behaviour, or discussing the patient among themselves, or other types of voices coming from
some part of the body.
82
Schizophrenia, Schizotypal and
Delusional Disorders
81
, Chapter 14: Schizophrenia, Schizotypal and Delusional
Disorders
Introduction
• Schizophrenia is a major psychiatric disorder, or cluster of disorders, characterised by psychotic symptoms
that alter a person’s perception, thoughts, affect and behaviour.
• Each person with the disorder will have a unique combination of symptoms and experiences.
• Typically there is a prodromal period often characterised by some deterioration in personal functioning. This
includes memory and concentration problems, unusual behaviour and ideas, disturbed communication and
affect, social withdrawal, apathy and reduced interest in daily activities. These are sometimes called ‘negative
symptoms’.
• The prodromal period is usually followed by an acute episode marked by hallucinations, delusions, and
behavioural disturbances. These are sometimes called ‘positive symptoms’ and are usually accompanied by
agitation and distress.
• Following resolution of the acute episode, usually after biological, psychological and other interventions,
symptoms diminish and often disappear for many people, although sometimes a number of negative
symptoms may remain. This phase, which can last for many years, may be interrupted by recurrent acute
episodes, which may need additional intervention.
• A significant number of people continue to experience long-term impairments and as a result, schizophrenia
can have a considerable effect on people’s personal, social and occupational lives.
• The disabilities experienced by people with schizophrenia are not solely the result of recurrent episodes or
continuing symptoms. Unpleasant side effects of treatment, social adversity and isolation, poverty and
homelessness also play a part.
ICD-10 classification
1. Schizophrenia
A. Paranoid schizophrenia.
B. Hebephrenic schizophrenia.
C. Catatonic schizophrenia.
D. Undifferentiated schizophrenia.
E. Post-schizophrenic depression.
F. Residual schizophrenia.
G. Simple schizophrenia.
2. Schizotypal disorder
3. Persistent delusional disorders
A. Delusional disorder.
B. Other persistent delusional disorders.
4. Acute and transient psychotic disorders
A. Acute polymorphic psychotic disorder without symptoms of schizophrenia.
B. Acute polymorphic psychotic disorder with symptoms of schizophrenia.
C. Acute schizophrenia-like psychotic disorder.
D. Other acute predominantly delusional psychotic disorder.
5. Induced delusional disorder
6. Schizoaffective disorders
A. Schizoaffective disorder, manic type.
B. Schizoaffective disorder, depressive type.
C. Schizoaffective disorder, mixed type.
1. Schizophrenia
ICD-10 criteria
• A minimum of one of the symptoms listed under (1) below, or at least two of the symptoms listed under (2),
should be present for most of the time during a period of one month or more.
• Conditions meeting such symptomatic requirements but of duration less than one month (whether treated or not)
should be diagnosed as acute schizophrenic-like psychotic disorder and reclassified as schizophrenia if the
symptoms persist for longer periods.
(1). At least one of the following must be present:
A. Thought insertion, withdrawal, echo or broadcasting.
B. Delusions of control, influence or passivity, clearly referred to body or limb movements or specific
thoughts, actions, or sensations; delusional perception. Hallucinatory voices giving a running commentary on
the patient’s behaviour, or discussing the patient among themselves, or other types of voices coming from
some part of the body.
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