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"Comprehensive Text Book of Psychiatry"

A. M. Freedman, M.D.
H.I. Kaplan, M.D.
The Williams & Wilkins Company. 1967 Baltimore


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Presentation created by Sandra Marchand-Smith

Psychology 120
Dr. Tom Doyle

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The symptoms of Schizophrenia have fascinated physicians and philosophers for thousands of years. As early as 1400 B.C., a Hindu fragment from the Ayur-Veda described a condition brought on be devils, in which the afflicted is "filthy, walk naked, has lost memory, and moves in an uneasy manner."

The 1st century A.D., the physician Aretaeus of Cappadocia noted the essential qualitative difference between patients suffering from the then traditional catch-all know as "mania" and those whom this gifted observer and clinician described as "stupid, absent and musing" possibly equivalent to the modern terminology applied to schizophrenics, whom we now describe as stuporous, preoccupied, and poor contact with reality.

Aretaeus also observed the deterioration of mental faculties and personality in some of his patients, who may well have been schizophrenics. Such patients, wrote Aretaeus, "fall into such a degree of degradation that, plunged into an absolute fatuousness, they forget themselves, pass the habits of their bodies lose all human dignity." Similarly, Aretaeus clearly described paranoid syndromes among those whom he called "melancholics," for example, delusion of being poisoned, withdrawal, and preoccupation with religion.

Sonarus, in the 2nd century A.D., described delusions of grandeur in patients who "believe themselves to be God" or who "refuse to urinate for fear of causing a new deluge". He also gave careful descriptions of stupor states.

After the early era of detached clinical interest and earnest attempts at treatment, the schizophrenic was cloaked for well over 1,000 years in the shadows of superstition and religious zeal. Countless schizophrenics judged to be possessed by the devil were burned at the stake or condemned and confined by society to jails and the unbelievable conditions of asylums such as Bedlam in England and Bicetre in France. During this period the schizophrenic was banished from the public eye and was virtually inaccessible to clinicians or scientists for study.


Schizophrenia afflicts approximately one percent of the world's population, making it the most common psychosis. Schizophrenia is characterized by positive and negative symptoms. Fundamental symptoms included thought disturbance, withdrawal, and difficulties managing affect. Secondary symptoms included perception disorders (e.g., hallucinations, grandiosity.) Symptoms may also be non-schizophrenic in nature, including anxiety, depression, and psychosomatic.

Subtypes of Schizophrenia

There are five recognized types of schizophrenia: disorganized, catatonic, paranoid, undifferentiated, and residual. Features of schizophrenia include its typical onset before the age of 45, continuous presence of symptoms for six months or more, and deterioration from a prior level of social and occupational functioning.

Disorganized Type

  • This subtype of schizophrenia is marked by significant regression to primitive, uninhibited, and disorganized behavior. Thumb-sucking, howling like a wolf, temper tantrums, creation of pornographic art and unreasonably strong cravings to suckle a female’s breast are characteristic of this type.

Catatonic Type

  • This subtype features gross psychomotor disturbances, i.e., stupor, negativism, mutism, rigidity, excitement, prolonged erection, or posturing. Frequent fluctuation between these extreme physical states is common. Schizophrenics of this type can be the most fun for psychologists to play with. They can be posed like dolls, undressed while they’re catatonic and then left in a crowded bus station to regain psychomotor normality, or even substituted for psychiatrists in therapy sessions. They pay essentially the same attention to a client’s problems as would any normal psychiatrist or therapist. The social and stimulatory benefits of the prolonged erection symptom are common knowledge among women.

Paranoid Type

  • More often than not, this is a misdiagnosed condition of prominent delusions or auditory hallucinations of persecution or grandeur, accompanied by a relative preservation of cognitive functioning. In reality, these are functionally normal individuals who have discovered the fact that some other individual or organization is conspiring or acting to torture, murder, or financially disable them, but are unable to produce legitimate evidence supporting their suspicions.

Undifferentiated Type

  • This type was originally designed as a catch-all category for psychiatrists and psychologists too incompetent to diagnose a schizophrenic’s specific type. It is allegedly used when patients do not clearly fit into any one type, fit into more than one type, or do not fit into any of the other types. Psychiatrists tend to categorize schizophrenics as undifferentiated pending the discovery or creation of new mental disorders to label them with.

Residual Type

  • This type commonly displays emotional bluntness, social withdrawal, illogical thinking, eccentric behavior, or mild loosening of association. Elderly people suffering from Alzheimer’s disease, lepers, philosophers and Japanese males who have “lost face” are characteristic of this type.
Age of Onset of Schizophrenia by Gender

Click, to enlarge graph.



Ayurveda means literally the 'science (Veda) of longevity', but because of its divine origins I have entitled this article 'Medicine of the Gods. It was originally a Hindu medical system and had its beginnings more than two and half thousand years ago in the sixth century before the present era (or if you prefer BC.). Ayurveda soon developed outside of the strictly Hindu community and was taken up and adapted by Buddhists and other religious groups. It has survived until the present day and is in fact undergoing a renaissance both in India and throughout the western world, which sees it as a necessary compliment to the Clinical model.

Ayurveda developed at about the same time as Buddhism and Hinduism and replaced earlier ideas on disease and Healing that were written down in religious texts such as the Atharva Veda. Until Ayurveda came on the scene, disease was usually explained in terms of possession by various demonic disease entities. This earlier 'system' was perhaps successful because disease was less frequent. But with the growth of cities and a more settled way of life, new diseases arose and as a response a new medical system was needed.



Aretaeus of Cappadocia:Greek physician from Cappadocia who practiced in Rome and Alexandria, led a revival of Hippocrates' teachings, and is thought to have ranked second only to the father of medicine himself in the application of keen observation and ethics to the art. In principle he adhered to the pneumatic school of medicine, which believed that health was maintained by “vital air,” or pneuma. Pneumatists felt that an imbalance of the four humours—blood, phlegm, choler (yellow bile), and melancholy (black bile)—disturbed the pneuma, a condition indicated by an abnormal pulse. In practice, however, Aretaeus was an eclectic physician, since he utilized the methods of several different schools.
After his death he was entirely forgotten until 1554, when two of his manuscripts, On the Causes and Indications of Acute and Chronic Diseases (4 vol.) and On the Treatment of Acute and Chronic Diseases (4 vol.), both written in the Ionic Greek dialect, were discovered. These works not only include model descriptions of pleurisy, diphtheria, tetanus, pneumonia, asthma, and epilepsy but also show that he was the first to distinguish between spinal and cerebral paralyses. He gave diabetes its name (from the Greek word for “siphon,” indicative of the diabetic's intense thirst and excessive emission of fluids) and rendered the earliest clear account of that disease now known.



Soranus:(sera´nes), fl. 1st-2d cent. AD, Greek physician, probably b. Ephesus. He is believed to have practiced in Alexandria and in Rome and was an authority on obstetrics, gynecology, and pediatrics. His treatise On Midwifery and the Diseases of Women(tr. 1882) remained an influential work until the 16th cent.



What is schizophrenia? | What are the causes? | What are the treatments?