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There are a number of signs and symptoms that are characteristic of schizophrenia. However, the expression of these symptoms varies greatly from one individual to another. No one symptom is common to all people and not everyone who displays these symptoms has schizophrenia (as some physical conditions can mimic schizophrenia).
Generally speaking, symptoms are divided into two groups, ’active’ symptoms (also referred to as ’positive’ or psychotic symptoms) that reflect new or unusual forms of thought and behaviour, and ’passive’ symptoms (also referred to as ’negative’ symptoms), which reflect a loss of previous feelings and abilities.
Positive / Negative Symptoms:
Delusions
Delusions are false personal beliefs held with extraordinary conviction in spite of what others believe and in spite of obvious proof or evidence to the contrary. For example, a person experiencing delusions may believe that thoughts are being inserted into their mind or that they have special powers or are someone famous (for example Jesus Christ or Elvis). People may also think that they are being spied on, tormented, followed or tricked, or may believe that gestures or comments are directed specifically at them. Delusions will occur during some stage of the disorder in 90% of people who experience schizophrenia.
Hallucinations
These are unusual or unexplained sensations, which are most commonly heard but can also be seen, touched, tasted or smelt. For example, the person may hear voices repeating or mimicking their thoughts, commenting on their actions (often in a critical manner), or they may hear voices arguing with one another. Auditory hallucinations occur in 50% of people with schizophrenia, while visual hallucinations occur in 15%.
Disorganised Thinking
This is a change in patterns of thinking and is usually expressed through abnormal spoken language. For example, the person’s conversation jumps erratically from one topic to another, new words may be created, the grammatical structure of language may break down, and speech may greatly speed up or slow down. Most people with schizophrenia will experience some degree of disorganised thinking.
Disorganised Behaviour
A person with schizophrenia may display behaviour that is considered inappropriate according to usual social norms, such as wearing unusual clothing, muttering aloud in public, or inappropriately shouting or swearing.
Negative / Passive Symptoms:
Withdrawal / Loss of Motivation
This may involve lack of energy, apathy or seeming absence of interest in things which loss of motivations were once previously enjoyed. There may be feelings of isolation and difficulties keeping up with work, school or daily routine.
Loss of feelings
This may manifest itself as an inability to experience pleasure in social and recreational activities or in close relationships. The ability to express or feel emotions can be greatly reduced, and consequently relationships can be severely affected.
Poverty of Speech
The amount of speech is greatly reduced and may sometimes be vague or repetitious. People may be slow in responding to questions or they may not respond at all.
Flat Presentation
This can be indicated by unchanging facial expressions, poor or no eye contact, reduced body language and decreased spontaneous movements. A person experiencing flattened affect may stare vacantly into space and speak in a flat toneless voice.
Cognitive Impairments
Although not included in diagnostic criteria, cognitive impairments such as problems with attention, concentration and memory, are often present in people with schizophrenia.
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