Abnormal Psychology

534 CHAPTER 12

100,000 individuals) are homeless, 5% are in hospitals, and 6%

are in jail or prison (Torrey, 2001). Together, these three groups of

people represent about 16% of Americans with schizophrenia; in

contrast, 34% of people with this disorder live independently (see

Figure 12.3).

Comorbidity

Over 90% of people with schizophrenia also suffer from at least

one other psychological disorder (American Psychiatric Association,

2000; Sands & Harrow, 1999). Substance- related disorders, mood

disorders, and anxiety disorders are the most common comorbid

disorders.

Mood Disorders and Anxiety Disorders

Approximately 80% of people with schizophrenia also have some

type of mood disorder, most commonly depression (Alexander,

1996; Sands & Harrow, 1999). As noted earlier, such individuals

are said to have a schizoaffective disorder. Iris Genain, for instance,

suffered from “deep depressions” and might today be diagnosed

with schizoaffective disorder. Many people with schizophrenia also

have signifi cant anxiety problems: Almost half of them also have

panic attacks (Goodwin, Lyons, & McNally, 2002) and anxiety disorders (Cosoff &

Hafner, 1998).

Substance-Related Disorders

Up to 60% of people with schizophrenia have a substance abuse problem that is not

related to tobacco (Swartz et al., 2006). Moreover, 90% of those with schizophrenia

smoke cigarettes (Regier et al., 1990), and they tend to inhale more deeply than do

other smokers (Tidey et al., 2005). One hypothesis for the high comorbidity with

Table 12.3 • Overview of Psychotic Disorders

Psychotic Disorder Features

Schizophrenia At least two symptoms, one of which must be positive, for

a minimum of 1 month; continuous symptoms for at least

6 months, during which time the individual has impaired

functioning in some area(s) of life.

Note: Full criteria are listed in Table 12.1.

Schizophreniform

Disorder

Symptoms meet all the criteria for schizophrenia except that

the symptoms have been present for only 1–6 months; daily

functioning may or may not have declined over that period

of time.

Brief Psychotic

Disorder

The sudden onset of positive symptoms or disorganization, which

persists between a day and a month, followed by a full recovery.

No negative symptoms are present during the episode.

Schizoaffective

Disorder

Symptoms meet the criteria for both schizophrenia and mood

disorder. Negative symptoms of schizophrenia are less common

with this disorder.

Delusional Disorder The presence of delusions that are not bizarre but are

demonstrably incorrect and that persist for more than 1 month.

Shared Psychotic

Disorder

(folie à deux)

Delusions that arise as a result of the individual’s close

relationship with another person who has delusions as part of

a psychotic disorder.

Source: Torrey, 2001.

The various psychotic disorders have in

common the presence of psychotic symptoms:

hallucinations and/or delusions. Although

schizotypal personality disorder is not a

psychotic disorder (because hallucinations

and delusions are absent), this personality

disorder is considered to be on the spectrum of

schizophrenia-related disorders.

Figure 12.3

12.3 • Distribution of the

2.2 Million Americans with

Schizophrenia

g 3

34%

25%

18%

7.5%

6%

5%

5%

Living

independently:

750,000

In supervised living

(group homes, etc.):

400,000

In nursing homes:

165,000

In jails and prisons:

135,000

In hospitals:

100,000

In shelters and

on the streets:

100,000

Living with a

family member:

550,000