• recognized the importance of personality 
• described several specific problematic personalities
• recognized that these were disturbed in the population
• Believed that a classification was not possible

• paranoid (untrusting) 
• schizoid (aloof) 
• schizotypal (strange)

• Antisocial (sociopathic) 
• Borderline (unstable)
• Histrionic (dramatic)
• Narcissistic (self-centered)

• Avoidant (of scrutiny)
• Dependent (of others)
• Obsessive-Compulsive (driven) 

• Neuroticism (N) 
• Extraversion (E) 
• Openness to experience (O)
• Agreeableness (A)
• Conscientiousness (C)

One's orientation towards others (altruistic versus antagonisitic 

Personality disorder- low agreeableness score

• "lumped together"
• Long-term deteriorating COURSE

Bleuler's fundamental symptoms

(4 a's)

• Association disturbance
• Affective disturbance
• Autism
• Ambivalence

delusions and hallucinations - accessory symptoms

Schizophrenia has an essence?

First rank symptoms

• Voices commenting on what one is doing
• voices discussing or arguing 

• DSM II 
• Psychoanalytic 

• Hallucination (without external stimulus) 
• Delusions (misinterpretation of perceptions or stimulus) 
• Disorganized speech 
• grossly disorganized and catatonic behavior

• Characteristic Symptoms
• Social & Occupational Symptoms 
• Duration 
• Not schizoaffective or mood disorders
• not substance/ general medical condition
• Relationship to PDD

Two or more of the following (each present for a significant portion of time during 1 month)

• hallucinations, delusions
• disorganized speech, cataonic behavior
• Negative symptoms 

• Catatonic type
• Disorganized type
• Paranoid type
• undifferentiated type 
• Residual type

• An episode of the disorder that lasts at least 1 month but less than 6 months
• Criteria A, D, E

Schizophreniform disorder with good prognosis

(2+)

• Onset of prominent psychotic symptoms within 4 months 
• confusion or perplexity at height of psychotic episode
• good premorbid social functioning
• absence of blunted affect

• Major depressive, manic or mixed state concurrent with Criteria A
• At least 2 weeks dellusions and hallucinations (no mood)
• Mood disorder present for substantial period 
• bipolar and depressive type

Non-bizzare delusions, little impairment

• erotomanic, grandiose, persecutory, jealous, somatic, mixed, unspecified

Brief Psychotic disorder

(more common in developing countries)

• Duration: at least 1 day but less than 1 month
• Presence of one or more symptoms of schizophrenia
• Specify: with marked stressors

• A  delusion develops in an individual in the context of a close relationship with another person who has an already established delusion
• Usually symptoms decrease once separated 

• Symptoms disproportionate to amount of substance use
• temporal relationship

• social interaction 
• communication 
• repetitive/restricted behaviors 
• delays or abnormal functioning in at least one of the areas must occur before the age of 3 years

• Insistence on sameness
• aloofness

• impairment in the use of nonverbal behaviors
• lack of spontaneous sharing
• lack of social/emotional reciprocity 
• failure to develop peer relationships

• Delay in or lack of development of spoken language or gestures
• impairment in ability to initiate or maintain conversation
• repetitive use of language
• lack of pretend play

• preoccupation with restricted patterns of interest
• inflexible adherence to routines
• repetitive movements 
• preoccupation with part or objects

• Changes in diagnostic criteria
• improvements in case recognition
• increased awareness of service delivery system 
• true increase?

• Ability to draw other's attentin to objects or events for the purpose of indicating a need or for sharing experiences 
• theory of the mind

• Delay in language
• inability to initiate or sustain conversations 
• lack of nonverbal compensatory efforts 
• lack of spontaneous make believe play

Preoccupation with one or more stereotyped and restricted patterns of interest

Inflexibility with regard to routine and rituals

stereotyped and repetitive motor mannerisms

persistent preoccupation with part of objects

• 71% have comorbid disorders 
• Medical (seizures, GI, sleep)
• Psychiatric (anxiety, depression, ADHD)

Autism Diagnostic Interview-Revised (parent)

Autism Diagnostic Observational Schedule (child) 

• the child must be verbal 
• semi-structured play interaction

• Behavioral intervention
• psychological/social skills intervention
• Speech/language interventions
• Occupational therapy
• family support
• Medications/CAMS