Schizophrenic Symptoms

Schizophrenia is classified as a “psychotic disorder” in the DSM-IV, which is the diagnostic manual used by mental health professionals. When a person is “psychotic,” it means he is unable to distinguish between what is real and what is imagined.

In more clinical terms, his “reality testing” is severely impaired. An individual with schizophrenia is not necessarily always psychotic, but may have periods of psychosis which are often referred to as “psychotic episodes.” These episodes make it impossible to function normally while they are occurring.

Psychotic symptoms primarily involve hallucinations or delusions, but there are also many other types of symptoms associated with schizophrenia. Following is a brief overview of schizophrenic symptoms, broken down into two categories: positive symptoms, and negative symptoms.

Positive Symptoms

Hallucinations
A hallucination involves one of the five senses (sound, sight, taste, touch, or smell), but occurs when there is nothing in the environment to stimulate the sense organ. In other words, a hallucination is an imagined (or unreal) sound, vision, etc. For example, a person who is having auditory hallucinations may be hearing voices or music playing, but these voices or sounds are only in his mind.
The most common type of hallucination that schizophrenics experience is an auditory hallucination. Many schizophrenics report hearing a voice or several voices. The voices may be telling the person to do something, such as harm himself or someone else. They may also be commenting on his actions or behavior. These voices can be very troubling and even frightening for the individual.
Delusions
A delusion is essentially a strongly held, but false belief that something which is not real is actually real, even when there is obvious proof or evidence to the contrary. Two examples of delusions would be a young man believing he is God, or that he is pregnant.
While delusions may involve many different themes, the most common type of delusion experienced by schizophrenics is a paranoid delusion. This often involves a belief that the person is being followed or spied upon by someone, such as the FBI. The person may believe that his phone is tapped and that there are video cameras hidden in his home. Paranoid delusions can be very frightening when they occur, causing the person to try to hide, protect himself, or run to somewhere safe. Other types of delusions may be grandiose, persecutory, jealous, erotomanic (sexual), or somatic (having to do with his body) in nature.
Disorganized speech
When a person’s speech is disorganized, he may often quickly go off the topic and talk about a variety of unrelated things. His speech may also be incoherent, making no sense to anyone who is listening. When someone’s speech is incoherent, his words or phrases are not connected in a way which is logical or meaningful. Sometimes this is referred to as “word salad” or gibberish.
Grossly disorganized behavior
Grossly disorganized behavior can show up in a variety of ways. For example, the person may dress in a bizarre or grossly inappropriate way, such as wearing multiple layers of clothing on a very hot day. He may be unkempt, completely neglecting his hygiene. He may become easily agitated without any provocation or trigger, or act very silly and childlike.
Catatonic behavior
Catatonic behavior involves the person’s movement, posture and responsiveness. For example, he may be completely unresponsive to his surroundings, as in a catatonic stupor. He may stand or sit in a rigid and / or bizarre position. When someone is catatonic, he may be very resistant to any attempt to move or reposition him. Catatonia may also involve excessive, excited movement that has no purpose and no trigger.

Negative Symptoms

The negative symptoms of schizophrenia are passive in nature. They affect the person’s thinking, emotion and behavior and can be the most devastating of all the symptoms. Three of the most common are flat affect, alogia, and avolition.

Flat affect
Flat affect is a common characteristic which means that the person shows little or no emotional expression or response.
Alogia
Alogia, which refers to impoverished thinking, occurs when the person’s speech is very limited in terms of content and lacks spontaneity.
Avolition
Avolition refers to the person’s inability to initiate and participate in any activity or task which is goal-oriented, such as dressing himself, performing a work-related function, or preparing a meal.

The Necessity of Treatment

Because the symptoms of schizophrenia are both severe and chronic, they generally severely impact the individual with this disorder. Treatment, particularly anti-psychotic medication, can play a significant role in helping the patient function more normally and alleviate or reduce the psychotic episodes. While there is no cure at this time, ongoing treatment is crucial for any individual diagnosed with schizophrenia.

by Dr. C. Lane, Psy.D.

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