Symptoms of Schizophrenia

The symptoms of schizophrenia can be categorised into three broad categories, namely, positive symptoms, negative symptoms and cognitive symptoms.

Positive symptoms

Psychotic behaviours constitute positive symptoms of schizophrenia. These behaviours are not seen in healthy people. A person with positive symptoms often loses touch with reality and the symptoms can come and go. The symptoms may vary in severity from hardly noticeable to severe. Positive symptoms of schizophrenia include:

a.    Hallucinations—the person sees, hears, smells or feels things that don’t really exist. Hearing voices is the common type of hallucination in schizophrenia and it usually starts much before family and friends notice the problem.

b.    Delusions— these are firmly-held ideas by the person, which do not change even though there is clear and obvious evidence that it isn’t true. More than 90% of people with schizophrenia have delusion. Some common delusions in schizophrenia include:

• Delusions of persecution – that is some people are out to get him or her. It often involves bizarre ideas and plots (such as my neighbours are trying to poison me).
• Delusions of reference –the person thinks that a neutral environment has special and personal meaning (such as the newspaper or a person on TV is sending a message meant specifically for him or her).
• Delusions of grandeur – the person has strong belief that he or she is a famous or important figure, such as Mahatma Gandhi or Napoleon.
• Delusions of control – the person believes that someone or an outside force is trying to control his/her thoughts or actions.

c.    Thought disorders—the person develops unusual or dysfunctional ways of thinking. In the “disorganized thinking” type of thought disorder, the person has trouble organising his or her thoughts or connecting them logically. Another form of thought disorder is called "thought blocking." In this, the person feels as if there is a loss of thought or the thought has been taken out of his or her head.

d.    Movement disorders—these appear as agitated body movements. The person may do a certain motion repeatedly. Some people may become catatonic i.e. the not move and respond to others.

Negative symptoms

Negative symptoms cause disruptions to normal emotions and behaviours. They are often difficult to diagnose as part of schizophrenia and can be mistaken for depression or other conditions. People, who develop negative symptoms usually, need help with everyday tasks. The negative symptoms are:

• "Flat affect" (the person's face is devoid of any expression and he or she talks in a dull or monotonous voice).
• Inability to feel any pleasure in everyday life.
• Inability to start and do planned activities.
• Withdrawn behaviour such as speaking little even when forced to interact.

Cognitive symptoms

In most cases, cognitive symptoms are subtle and it may be difficult to associate these symptoms with schizophrenia. They are generally detected when others are performed. Some of the cognitive symptoms include:

• Poor "executive functioning" (the potential to comprehend information and apply it to make decisions).
• Difficulty in focusing or paying attention.
• Troubles with "working memory" (the capability to apply information directly after learning it).

Cognitive symptoms limit the person’s capability to lead a normal life and earn a living and can therefore, be a cause great emotional distress.