DSM EDITIONS

DSM I - 1952

DSM II - 1968

DSM III - 1980

DSM III R - 1987

DSM IV - 1994

DSM IV - TR - 2000

DSM 5 - 2013

IQ LEVELS
50-55 - 70 : Mild

35-40 - 50-55 : Moderate

20-25 - 35-40 : Severe

Below 20-25 : Profound

ASD LEVELS
speech & social
interaction respectively

L e v e l 1 : A s p e r g e r ’s
disorder (ability, reduced)

Level 2: Rett’s disorder

(minimum)

Level 3: (lack, no)

Schizophrenia (phases)
Prodrome

Active

Residual

SCHIZOPHRENIA
Prevalence: 1 in 100

Gender: equally
prevalent; early onset
Male (10-25); Female
(25-35)

Late onset: after age

40

Outcome: better social

functioning (female),
impaired by negative
symptoms (male)

4 A’s IN SCHIZ
Association

Affect

Autism

Ambivalence

ETIOLOGY:
GENETIC FACTORS:
10x greater risk to
develop for 1st degree
biological relatives

Vulnerable are those born

from fathers older than
the age of 60

BIOCHEMICAL FACTORS:
To o m u c h d o p a m i n e rg i c
activity (mostly positive
symptoms)

Serotonin (both positive and

negative symptoms)

Norepinephrine: Anhedonia
(impaired ability for emotional
gratification)

Loss of GABA: hyperactivity of

dopamine

Reduced symmetry in several

brain area including temporal,
frontal & occipital

Smalle size: Limbic system.

Hippocampus, amygdala

Five subtypes of
schizophrenia
1 Paranoid

2. Disorganized

3. Catatonic

4. Undifferentiated

5. Residual

SCHIZOAFFECTIVE
DISORDER
Prevalence: less than 1
percent

Gender differences: Parallel

Bipolar: Equal men & women

Depressive subtype:
predominant on women

Depressive subtype: older

Bipolar type: younger

Age of onset: later for

women

Men with schizoaffective

disorder: likely to exhibit
antisocial and markedly flat
or inappropriate affect.

Better prognosis than

Schizophrenia but worse
prognosis that mood disorder

Respond better to lithium

than schizophrenia, non
deteriorating course

Unknown cause

 MSE
MOTOR ACTIVITY: Normal,
Slowed (bradykinesia) or agitated
(hyperkinesia)

SPEECH: fluency, amount, rate,

tone & volume

Fluency: command of English

Language

Amount of speech: normal,

increased (mania/hypomania);
decreased (anxiety. Disinterest,
psychosis)

Rate of speech: Slowed or Rapid

(pressured?)

Tone & Volume: irritable, anxious,

dysphoric, loud, quiet, timid,
angry, childlike

 MSE
AFFECT: quality, quantity,
range, appropriateness and
congruence

Quality: tone: dysphoric,

happy, euthymic, irritable,
tearful, sobbing

Quantity: intensity

Range: restricted (flat:Schiz),

normal, labile (changing)

Appropriateness: correlates
to setting

Congruent: incongruent/
congruent to described mood

 MSE
THOUGHT CONTENT:
thought occurring to client/
responses to questions.
Obsessional, compulsions,
delusions, paranoia,
suicidality and homocidality

THOUGHT PROCESS: How

thoughts were formulate/
organized

PERCEPTUAL
DISTURBANCES:
Hallucinations, Illusions,
Depersonalization,
derelaization

 MSE
COGNITION: sensorium,
attention, memory, fund of
knowledge, insight &
judgment, concentration

INSIGHT: No, partial or

full (understanding of how
one is feeling and
functioning)

JUDGMENT: Decision
making, if do things that
are dangerous