MENTAL SYMPTOMS: SCHIZOPHRENIA

[Music] if the schizophrenic patient does not recover he may deteriorate as time goes on there's a characteristic lack of interest in the environment withdrawal from contact with others and with it goes an increasing loss of emotional response these people become vague and empty their manner is childish and they are gawking they show little or no initiative in spontaneity if they do react emotionally their reaction is often inappropriate they have of course no real plans for the future in spite of this general impoverishment of their personality many of their intellectual functions remain intact memory and orientation are not impaired the patient we are going to see is about 40. she has been sick for more than 10 years lives quietly in the hospital doing simple work in the laundry she seldom speaks unless spoken to and does not mix with the other patients but she is really quite contented and her lack of energy and animation is not due to depression and despondency but to apathy she might during the interview demonstrate an appropriate emotional reaction particularly smiling or laughing when discussing serious subjects she complains of auditory hallucinations voices and strange feelings of being controlled by unseen forces though these are not especially common symptoms in the simple type of schizophrenia and how long have you been here i i think i think that'd be 14 months in december beginning of december in this place do you like it here yes i like it when it's quiet do you like it when it's quiet i find it too noisy though all those sometimes it's noisy here because of the other patients probably why do you like it better when it's quiet have you always liked it quiet or i've been used to living where it's quiet except for the railway you told me once that you didn't like the radio yes in the hospital i was unhappy when they brought the radio why the ward was quieter without it well if you're very quiet what are you doing are you reading or are you thinking i'm not reading you know you don't like reading what are you doing music better listening to music and not talking you like that music is the best i mean you told me another time that sometimes you hear voices talking to you can't see the people does that happen often yes i think it's all day yes i i don't think i have my head's never been free of anybody talking can you hear them now since i was a young girl can you hear them now oh it's quiet now i can talk and i can talk without them you can talk without whom they take away my talking the voices yes how does it do it can you tell me what they're saying i mean i don't pay any attention to what they say but you understand them why did you come here vera after being sick are you still sick no i'm much better now but you like staying here have you seen your family lately no i haven't aren't you feeling lonesome yes i was wishing i had a visitor they haven't seen you for a long time yeah have you written them no i haven't i don't like writing letters do they write you no i haven't received any letters either i didn't know i think you might have a visit soon possibly if i'm good you know what day it is today thursday you know what time it is about when i laughed at 12. that's quite right 10 minutes past 12. did you see the paper today no i haven't why not don't like reading i don't like magazines i hate magazines [Music] where's your head going what would you like to do now vera i was playing the piano i i was enjoying playing the piano for a few moments and afterwards what are you going to do next year i like to play the piano next year well let's suppose um just for a minute that you would have a hundred thousand dollars yeah what would you do with it hospital needed help the hospital needed it you mean you would give it to the hospital and what would you do i expect them to keep me up i need you to keep your head yeah because you like it here how do you feel i'm feeling better thank you feeling better are you sleeping well yes i'm thinking better now what's your appetite you must be feeling very lonesome being alone so long are you yes i was early yes why are you smiling have you any friends here yes i have to met you are you seeing them every day yes i think so and what do you do you talk to them when when i'm allowed to yes you're always allowed to you know oh yes and what would you like to do now probably it's time to go back for the full lunch show you just had your friendship how long ago half an hour half an hour are you hungry again no well let's go anyway better get a cup of coffee yes all right you have seen in this patient apathy indifference inappropriate emotional reaction she was smiling when asked about loneliness general gracelessness of posture total lack of ambition and initiative with no real plans for the future hallucinations but her memory and orientation are intact and she was quite coherent a characteristic picture of chronic simple schizophrenia a number of chronic schizophrenic patients present the hepatic picture the patient we will see is in a far advanced state marked by extreme deterioration affecting intellect emotions and behavior the characteristic symptoms consist in general dishevelment and totally disregard for appearance mannerisms expressed in stereotype movements and speech silly behavior often accentuated by meaningless laughter and grotesque grimacing thinking is characterized by poverty of ideas and marked disorganization often resulting in irrelevant and incoherent senseless speech vivid hallucinations are also a common symptom the hepaphranic patient who is distractible and interfering is more active than any other schizophrenic type the patient we are presenting was first admitted to the hospital 13 years ago with a schizophrenic breakdown of the catatonic type at that time a photograph of him in catatonic stupor was taken which we will show the patient during the interview he is now hypochronic such a shift from one schizophrenic pattern to another is not unusual over the course of years i can't hear you joe can you take a little louder hey you got that job yeah i look for you somewhere i don't know look yes sir yes it is see this is the boy you hold it look at it that's you that's me can i tell you that's you yes me oh yeah dora chester is there no no oh yeah why are you sitting in that way why are you sitting that way are you sick then he's not sick he's a heart yes well and you are this man i was racing i said huh yeah so many years ago on the streets downtown you see uh yeah you make money well you have no job you stay home sit down [Music] who's the boy who's that boy joe hold up boys 25 years old you buy and now you're you're on this place you're on this place cheryl is special don't die about south i come here how long have you been here i've been here about 900 years hollow this place how long have you been here been here 100 years 900 years yeah yeah that's a very long time couldn't help but give up his place if i check on our cigarettes i paid [Music] huh who drives the car i can't hear who drives the car cars you anybody i don't know i go on the stage downtown up down i see he's everywhere but you're in the hospital now are you sick sometimes i broke a finger and lots of beer this is not the montreal tramway someone talked that way no american city what is it a sanitarium it's not a sanitarium what is this this is the world around the streets is evident that's a boy around the streets oh he doesn't have any sick he's everything he's sick are you sick joe sick and uh you're sick in the blood how do you feel oh i'm sick in the winter how how old are you huh how old are you 25 years old oh what is this boy well he's about 20. what would you like to do now what would you like to do now joe what would you like to do now now we're on the streets around the streets would you like a coke would you like a coke sure yeah well let's see i that you tell me what it is city yeah all these dummies it's what cinco is in a streetcar yeah where's streetcar downtown ontario and everything i see what did you tell me about your heart huh how's your heart my heart is all right she's a man and you work all over the world yes i work where do you work i work in the factory 15 years i think did you work did you work in england yeah city all over the world all over the world how do you get there huh how do you get there i get it with my fluffy on your four feet faster you have only two feet take a street car and then go to work and you go home how much money do you have hundred dollars a week another week yeah but you're in the hospital you're not me yeah in the hospital yourself what about the arrested arresting yeah i was arrested i got that i punched ourselves i took another piece of paper you catch it all on a piece of paper i catched our man he got me arrested that boy piece of paper you're a provincial policeman yeah yeah what am i doing you're not a punisher i'm the monopoly yeah yeah that's someone who believes well i'm a doctor i'm a doctor john ah i'm a doctor oh you're a doctor a place is a doctor a dentist well a policeman isn't a dentist sure what's that what's a policeman doing this one's identity there's nothing to say policeman is a dentist church i'm all the parts of the world what is that i know from the hospital all parts over the world that's me that's you oh what's your part of the city what's you joe what is you what i do my name is work officer copenhagen all over the world what are you doing just what did you do you were going to tell [Music] 1900 there's no politician there oh yeah looks worth your harassment there's no problem there's no politician there's a pakistan man yesterday well you speak english english english you can speak english don't you yeah i'll do south english can you speak french french i live in a little bit do i go to any doctor langley what england you want to go to england yeah to go to see the americans in england michigan american city in england why not that's a dollar this is americana where's the dollar yeah there's no dollar there sure yeah taylor excellent in the two interviews the patient showed untidy appearance stereotype mannerisms disorganized thinking and poverty of ideas irrelevant and incoherent speech which sometimes trails off into unintelligible muttering it is often difficult to gain his attention because he's so easily distracted and sometimes preoccupied we have also seen the senseless laughter and grimacing which is the most obvious characteristic of the hypochronic you