1 APRIL 2022 ausdoc . com . au
Figure 1 . Model of the onset and progress of a psychotic illness like schizophrenia .
Fusar-Poli , P . Et al ( 2017 ) European Psychiatry ; Cambridge University Press 8
Figure 2 . Early and late life stressors interacting with genetic vulnerability may lead to schizophrenia .
Drugs Famine
Child abuse
Infection Migration Autoimmunity
understanding the management . To diagnose schizophrenia , the signs and symptoms of the disorder need to persist for at least six months , accompanied by a deterioration in the level of functioning , in the absence of other possible aetiologies . 11
Hallucinations can occur in any sensory modality — auditory , visual , olfactory , gustatory or tactile ( see figure 5 ). A hallucination is a sensory perception experienced in the absence of real stimuli . Although auditory hallucinations are typical of schizophrenia , they are not
Table 1 . Signs and symptoms of schizophrenia Positive Negative Disorganisation Mood Cognitive
Hallucinations ( eg , hearing voices ) Delusions ( eg , persecutory , bizarre , grandiose ) Impaired insight
pathognomonic and can occur in several other psychiatric and neurological diseases .
Delusions are false fixed beliefs that are out of keeping with the
Lack of motivation Anhedonia Blunted affect Reduced speech content and output Social withdrawal
individual ’ s community . They are diverse , but typically include delusions of persecution in which the individual fears they or their family are threatened or in danger .
Disorganised thinking and speech Disorganised behaviour Aggression Hostility Catatonia
Depression Anxiety
Sometimes these persecutory delusions can be systematised and refer to groups such as criminal organisations , a secret service , government or religious organisations , who
↓ Attention and concentration ↓ Mental flexibility ↓ Memory ↓ Social cognition
in the patient ’ s mind , are plotting to harm them ( see figure 6 ). Delusions of reference describe ideas that place the individual in a world where everything is directed , or