Schizophrenia-Signs and symptoms

   

Schizophrenia is a brain disorder that affects how people think, feel, and perceive. The hallmark symptom of schizophrenia is psychosis, such as experiencing auditory hallucinations (voices) and delusions (fixed false beliefs).

Signs and symptoms

The symptoms of schizophrenia may be divided into the following 4 domains:

·         Positive symptoms - Psychotic symptoms, such as hallucinations, which are usually auditory; delusions; and disorganized speech and behavior

·         Negative symptoms - Decrease in emotional range, poverty of speech, and loss of interests and drive; the person with schizophrenia has tremendous inertia

·         Cognitive symptoms - Neurocognitive deficits (eg, deficits in working memory and attention and in executive functions, such as the ability to organize and abstract); patients also find it difficult to understand nuances and subtleties of interpersonal cues and relationships

·         Mood symptoms - Patients often seem cheerful or sad in a way that is difficult to understand; they often are depressed

The patient must have experienced at least 2 of the following symptoms :

1. Delusions
2. Hallucinations
3. Disorganized speech
4. Disorganized or catatonic behavior
5. Negative symptoms

At least 1 of the symptoms must be the presence of delusions, hallucinations, or disorganized speech.

Continuous signs of the disturbance must persist for at least 6 months, during which the patient must experience at least 1 month of active symptoms (or less if successfully treated), with social or occupational deterioration problems occurring over a significant amount of time. These problems must not be attributable to another condition.

Hallucinations: A hallucination is a perception in the absence of external stimulus that has qualities of real perception.

Delusion:  unshakable beliefs in something untrue or not based on reality. People with delusional disorder generally experience non-bizarre delusions.

Types of Delusion

Erotomanic. These individuals believe someone is seriously in love with them, more in the Hollywood romance, even spiritual way, rather than in the sexual sense.

Grandiose. These are sometimes called delusions of grandeur and manifest when a person believes (with no evidence) that they are special. Often the delusions are religious for those with the disorder, often believing that they have a unique and privileged relationship with the "The Almighty."

Jealous. This is clearly manifested in the strong, but unfounded belief that a partner is unfaithful and cheating on them

Persecutory. This is the belief that someone or some group is conspiring against them. They could be cheating, spying on, harassing, or gossiping about them, or even attempting to poison or drug them.

Somatic. This is the delusion that one’s body is somehow strange or not functioning properly. It may be the belief that one smells odd, or that particular parts (nose, breasts, feet) are particularly odd, misshapen or ugly.

Types of Negative symptoms

Anhedonia: Decreased ability to find pleasure in everyday

Avolition: Diminish ability to begin and sustain activities

Alogia: Decreased speech even when encouraged to interact

Asociality: Social Withdrawal

Affective flattening:  lack of emotional and facial expressions

Subtypes of Schizophrenia:

Schizoaffective disorder: a person must have experienced mood disorders for most of the time they have also had the psychotic symptoms of schizophrenia, from when they first started having symptoms up to the present.

Catatonia: it includes extremes of behavior:

·         Catatonia can include excessive and peculiar motor behaviors, sometimes referred to as catatonic excitement

·         Catatonia can also include decreased motor activity and engagement. For example, people in a catatonic stupor demonstrate a dramatic reduction in activity, where the patient cannot speak, move or respond. Virtually all movements stop.

Childhood onset schizophrenia: The symptoms of schizophrenia normally appear during early adulthood, but they can sometimes emerge during childhood, at the age of 10 years or earlier. It is extremely rare, with an incidence of less than 0.04 percent. If schizophrenia occurs in a child, it is very serious, and treatment is needed.

Disorganized schizophrenia, or hebephrenia: Disorganized thinking and behavior are features of schizophrenia. The person may have incoherent and illogical thoughts and speech.

Paranoid Schizophrenia: A person with schizophrenia may have false beliefs, or delusions, that an individual or group of people are conspiring to harm them or members of their family. They may spend time thinking about ways to protect themselves from the people they believe are persecuting them.