![]() The course of the disorder shows equally great variation and is by no means inevitably chronic or deteriorating (the course is specified by five-character categories). The onset may be acute, with seriously disturbed behaviour, or insidious, with a gradual development of odd ideas and conduct. Ambivalence and disturbance of volition may appear as inertia, negativism, or stupor. Mood is characteristically shallow, capricious, or incongruous. Breaks and interpolations in the train of thought are frequent, and thoughts may seem to be withdrawn by some outside agency. Thus thinking becomes vague, elleptical, and obscure, and its expression in speech sometimes incomprehensible. In the characteristic schizophrenic disturbance of thinking, peripheral and irrelevant features of a total concept, which are inhibited in normal directed mental activity, are brought to the fore and utilized in place of those that are relevant and appropriate to the situation. Perplexity is also common early on and frequently leads to a belief that everyday situations possess a special, usually sinister, meaning intended uniquely for the individual. Perception is frequently disturbed in other ways: colours or sounds may seem unduly vivid or altered in quality, and irrelevant features of ordinary things may appear more important than the whole object or situation. Hallucinations, especially auditory, are common and may comment on the individual’s behaviour or thoughts. The individual may see himself or herself as the pivot of all that happens. The most intimate thoughts, feelings, and acts are often felt to be known to or shared by others, and explanatory delusions may develop, to the effect that natural or supernatural forces are at work to influence the afflicted individual’s thoughts and actions in ways that are often bizarre. The disturbance involves the most basic functions that give the normal person a feeling of individuality, uniqueness, and self-direction. ![]() Clear consciousness and intellectual capacity are usually maintained, although certain cognitive deficits may evolve in the course of time. The schizophrenic disorders are characterized in general by fundamental and characteristic distortions of thinking and perception, and by inappropriate or blunted affect. (Since the WHO updates the overall ICD on a regular basis, individual classifications within it may or may not change from year to year therefore, you should always check directly with the WHO to be sure of obtaining the latest revision for any particular individual classification.) F20 Schizophrenia The following information is reproduced verbatim from the ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization, Geneva, 1992.
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