Schizophrenia Symptoms - OmniMedicalSearch.com

Conditions & Diseases: Psychological & Mental Health

Schizophrenia

Schizophrenia Symptoms

Today, many psychiatrists have agreed that schizophrenia is defined by at least three different sets of symptoms, classified as:

I. Positive symptoms (Psychotic)
II. Negative symptoms
III. Cognitive symptoms

I. Positive (or psychotic) symptoms, according to DSM-IV, "reflect an excess or distortion of normal functions" and include: delusions, hallucinations, disorganized speech, and disorganized or catatonic behavior. These symptoms can be effectively treated with antipsychotic medication.

1. Delusions are defined as "erroneous beliefs that usually involve a misinterpretation of perceptions or experience" and cannot be accounted for by the persons cultural or religious background or level of intelligence. (2) A person experiencing delusions strongly believe in their beliefs and will hold firmly to them regardless of the logical arguments and evidence presented. According to the delusion's content theme, schizophrenics can experience several different types of delusions, such as:

Persecutory delusions. They are the most common form of delusions experienced in schizophrenia, and their content evolves around the theme of being spied on, followed, ridiculed, tricked, cheated, conspired against, etc. These persecutory delusions usually involve bizarre ideas and plots.
Referential delusions. According to these delusions certain events, objects, remarks, gestures, comments, passages from a book, newspapers, songs lyrics, news, or environmental clues have a personal meaning or are directed to the individual.
Somatic delusions. These delusions focus on the diseased, changed, or abnormal characteristic of a bodily functioning, bodily sensation, or physical appearance. For example, the patient can believe that their body is infested by parasites or that their organs were removed and replaced with someone else's organs by a stranger that left no wounds or scars.
Religious delusions. This type includes any delusion with a religious or spiritual content. Some of these delusions can have grandiose characteristics such as the belief that the person was chosen by God. However, religious delusions vary across cultures and in some cases, can lead to violent behaviors.
Grandiose delusions. They express the individual's beliefs that they posses special powers, talents, abilities, are famous people, or have accomplished great achievements for which they never received sufficient recognition.

2. Hallucinations are false or distorted sensory experiences generated by the mind and not by external stimuli which appear to the person as real perceptions. The most common hallucinations experienced by individual with schizophrenia are:

Auditory hallucinations. This type is by far the most common hallucination described by schizophrenics. They are mostly experienced as familiar or unfamiliar voices or sounds. A typical auditory hallucination in schizophrenia is one where there is, "two or more voices conversing with one another or voices maintaining a running commentary on the person's thoughts or behavior." (3) In many cases, these voices are critical, vulgar, or abusive. Auditory hallucination tend to get worse when the person is alone. When severe, these hallucinations intrude into the person's life and activities, and the patient can even respond to them as if in conversation.
Visual hallucinations. This type of hallucinations are also divided in simple (elementary or non-formed) hallucinations such as dots, colors, flashing light, or geometric patterns, and complex (formed) hallucinations such as objects, animals, or people.
Olfactory hallucinations (smell).
Tactile hallucinations (touch).

3. Disorganized speech. One of the characteristic features of schizophrenia is fragmented thinking. Fragmented thinking can be observed in the way the person talks (disorganized speech). This disorganization can vary in patients with schizophrenia. Some individuals can "slip out of track" from one subject to another, speek incoherently, or express illogical thinking. When answering questions, schizophrenics can "be obliquely related or completely unrelated." (4)

Some of the most common signs of disorganized speech include:

Loose associations - The person rapidly shifts the conversation subject from one topic to another without connecting them.
Neologisms - Neologisms, in schizophrenia, refer to those made-up words or phrases that make sense only for the patient.
Perseveration - The patients repeats the same words or statements over and over.
Clang -The patient uses different rhyming words in an order that doesn't make sense.

4. Grossly disorganized or catatonic behavior. Disorganized behavior can manifest in various ways such as: childlike silliness, unpredictable agitation (shouting or swearing, muttering aloud in public), difficulties in performing activities of daily living (preparing meals or maintaining a proper hygiene), dressing in a bizarre manner (such as wearing multiples scarfs, multiple coats, or unsuitable cloth for the outside weather - gloves on a hot day), or display inappropriate sexual behaviors (masturbating in public). On the other hand, individuals suffering from schizophrenia also display what is called a catatonic behavior. This behavior is characterized by muscular tightness (rigidity) and lack of response to the environment. In severe cases, the catatonic behavior can reach an extreme degree of complete unawareness (condition known in medical terms as catatonic stupor) when the body maintains a rigid posture and resists the efforts to be moved.

II. Negative symptoms are those symptoms that reflect the loss of normal functioning, and include: flat affection, avolition (withdrawal, loss of motivation, and ambivalence), anhedonia (loss of feeling or inability to express pleasure), and alogia (poverty of speech). Approximately 25 percent of the patients with schizophrenia display what is called the deficit syndrome "defined by severe and persistent negative symptoms" (5). Unfortunately, negative symptoms are the main reason why individuals with schizophrenia cannot live an independent life, hold jobs, and establish personal relationships.

1. Affective flattening is a common symptom in schizophrenia, and is characterized by unchanging facial expressions where the face appears immobile and unresponsive, poor or no eye contact, reduced body language, and decreased spontaneous movements. A person with affective flattening "may stare vacantly into the space and speek in a flat, toneless voice." In certain occasions, an individual with affective flattening can smile or warm up, however their range of emotional expressiveness is diminished most of the time. (6)

2. Avolition is a symptom characterized by the absence of initiative or motivation to begin or maintain a goal-directed activity. This symptom involves a lack of energy, increased apathy, and/or lack of interest in daily activities. A person with avolition may sit for hours doing nothing and show little interest in engaging in social or work activities. They can lack the desire to maintain proper personal hygiene or to groom, and have difficulties taking decisions. When these symptoms occur in the clinical picture, it significantly interferes with the individual's ability to function normally in the work, social, or household settings.

3. Anhedonia represents the inability to feel joy. This symptom manifests when the individual lacks the interest in social or recreational activities and fails in developing close relationships.

4. Alogia or "poverty of speech" is characterized by "brief, laconic, empty replies." Individuals with alogia appear "to have a diminution of thoughts that is reflected in decreased fluency and productivity of speech", they tend to be vague and repetitious. (7) However, this symptom should not be confused with the lack of desire to speek.

III. Cognitive symptoms (or impairments) also called cognitive dysfunctions or disorganized symptoms are often present in people with schizophrenia. However, this type of symptom is subtle and is usually detected when the patient undergoes neuropsychological tests. Some of the common cognitive impairments associated with schizophrenia are:

Difficulties prioritizing tasks and organizing their thoughts.
Trouble with logical thinking.
Confused and disordered speech.
Inability to sustain attention.
Difficulties making decisions.
Problems with memory.
Lack of insight into their condition.

Unfortunately, these symptoms interfere with the individual's ability to manage their own life by living a normal life or earning a living, usually causing significant emotional distress.

Article by Alina Morrow,
MS Psychology
OmniMedicalSearch.com