Psychiatrists make out a diagnosis of schizophrenia very carefully. After all, this is kind of a verdict. Although the diagnosis isn’t made out immediately, everyone needs to know schizophrenia symptoms in order to suspect the pathology in time, turn to a psychiatrist, and begin adequate treatment.
What Is Schizophrenia?
Schizophrenia as a disease was discovered only two centuries ago. At that time physicians began to describe the main schizophrenia symptoms and choose methods of treatment. Previously, this disease was considered a vice, diabolizing. Also, people explained it by supernatural theories.
Schizophrenia is a polymorphic mental disorder or a group of mental disorders associated with the breakup of the processes of thinking and emotional reactions. Schizophrenic disorders are generally characterized by certain fundamental disorders of thinking and perception as well as inadequate or decreased affect. In other words, schizophrenia is a mental disorder characterized by abnormal social behavior and failure to understand what is real. The most frequent manifestations of the disease are auditory hallucinations, paranoid or fantastic delirium or disorganization of speech, and thinking against a background of significant social dysfunction and disability.
The overall risk of the disease, according to the research, is 0.4-0.6% (4-6 cases per 1000 people). Men and women are equally prone to schizophrenia. At the same time, women tend to have a later onset of the disease. Thus, the average age of schizophrenia manifestation is 23-30 years in women, and 18-25 years in men.
What Are the Symptoms of Schizophrenia?
Schizophrenia symptoms are divided into three categories:
Positive symptoms. These include abnormal thoughts and judgments, including hallucinations, delusions, thought disorders, and motor disorders.
Negative symptoms are expressed in the loss or decline of the ability to plan, express oneself, express emotions or enjoy everyday life. These symptoms are more difficult to recognize as manifestations of schizophrenia. They can be mistaken for being lazy or depressed.
Cognitive symptoms (or cognitive impairments) are problems with concentration and attention, certain types of memory, and controlling functions responsible for our ability to plan and organize. Cognitive impairment is also difficult to recognize as a symptom of the disease but it has the greatest impact on the ability to lead a normal lifestyle.
Positive Symptoms of Schizophrenia
Positive symptoms are easily recognizable behaviors that are not common to healthy people. Usually, they are associated with a loss of connection with reality. These include hallucinations, delusions, mental disorders, and movement disorders. Positive schizophrenia symptoms may appear and disappear. Sometimes they are manifested in severe form; sometimes they are hardly noticeable. Everything depends on the treatment.
Hallucinations are a violation of the perception of the surrounding reality through the senses. This means that hallucinations are some sensations that do not exist in reality. Depending on what kind of sensory organs are related to hallucinations, they are divided into auditory, visual, olfactory, tactile, and tasteful. In addition, hallucinations can be simple (individual sounds, noises, phrases, flashes, etc.) or complex (coherent speech, certain scenes, etc.).
The most common are auditory hallucinations when a person hears voices in their head or in the surrounding world. Sometimes it may seem that thoughts are not produced by the person themselves but are inserted into the brain, etc. Voices and thoughts can give commands, advise something, discuss events, speak vulgarities, laugh, etc. What’s more, a lot of patients hear voices that comment on their behavior, order them to do something, warn about imminent danger or talk with each other (usually about the patient).
People who suffer from schizophrenia can hear such voices for a long time before relatives or friends notice that something is wrong. Other kinds of hallucinations include visions of non-existent people or objects; the smell of odors which no one else feels (although this may also be a symptom of some brain tumors); and imaginary tactile sensations. For example, a sick person may feel that someone is touching them when no one is around.
Delusion is a collection of certain beliefs, conclusions, and inferences that are completely untrue. It can be an independent or provoked hallucination. Depending on the nature of the belief, there are delusions of persecution, influence, power, grandeur or attitude.
The most frequent is the development of delusions of persecution when a person thinks that they are persecuted by someone. For example, by aliens, parents, children, police, etc. Every minor event in the surrounding space seems to be a sign of tracking.
Patients with schizophrenia have absolutely abnormal delusions. For example, they may be sure that neighbors control their behavior with the help of magnetic waves, people on television broadcast special messages to them, or that radio stations voice their thoughts to other people in broadcasts. They can also develop delusion grandeur and the belief that they are famous historical figures. People with paranoid schizophrenia may think that others intentionally deceive them, mock, try to poison, spy on them or plot against them and their loved ones. Such representations are also called delusions of persecution.
In patients with schizophrenia, abnormal forms of the mental process are often observed. One of the most significant is disorganized thinking. It means that it is difficult for a person to systematize their thoughts or logically connect them. The speech may be incoherent or difficult to understand. Another form is a “retardation of thought” when a person stops suddenly in the middle of a thought. If you ask why they stopped, then a person can respond that it seems that someone has taken the thought out of their head. Finally, a person can create incomprehensible words or “neologisms”.
Patients with schizophrenia can experience awkward, uncoordinated, and involuntary movements, grimaces or strange mannerisms. They can repeat certain movements again and again or fall into a catatonic state – a state of immobility. The catatonic syndrome was more common when there was no treatment for schizophrenia. Now, fortunately, this schizophrenia symptom is rare.
Depersonalization and Derealization
Also, an important sign of schizophrenia is the syndrome of depersonalization and derealization. It is characterized by the fact that the patient’s perception of their personality and surrounding reality is disturbed. The surrounding world seems unreal, “as in a dream”. Or a person believes that the events of their life are not happening to them.
Negative Symptoms of Schizophrenia
The term “negative symptoms” means a decrease in the normal emotional potential and level of behavior:
- “flattened effect” (fixed facial expression, monotonous voice),
- inability to enjoy anything in everyday life,
- weakened ability to plan and carry out the assigned tasks,
- poor speech, even if you need to communicate.
Patients with schizophrenia often disregard the rules of basic hygiene. So, in everyday life, they need outside help. Since it is not obvious that negative symptoms are manifestations of mental illness, schizophrenia patients are often considered simply lazy and unwilling to improve their lives.
Negative Signs of Schizophrenia
Negative schizophrenia symptoms usually appear after the first psychotic episode. They are characterized by a decrease in social activity, offishness, a desire for solitude, a slow reaction. The symptoms are increasing and manifesting more clearly with time. With each new psychotic episode, negative symptoms aggravate. That is why it is extremely important not to allow new exacerbations, to make preventive visits to the doctor on time, and to follow their recommendations to the letter.
Negative Schizophrenia Symptoms Include:
- Loss of attention and worsening of thinking. It is difficult for a patient to concentrate on something. They are not able to fully remember information. It is difficult for the patient to switch between tasks.
- The poverty of speech: a decrease in the speed of speech, a reduction in the number of used words, long pauses in conversations, often incoherence in speech.
- The decrease in social activity and loss of interests. The patient becomes reserved, taciturn, and passive. Initiative and ability to work decreases as well.
- Catatonia: stupor, constant muscle tension or vice versa – relaxation and reduction of muscle tone.
Also, schizophrenia is characterized by depressive conditions. Sometimes there are outbreaks of aggression, tearfulness. There is a depletion of emotions. As a result, it becomes difficult for the patient to recognize the emotions of other people, which leads to difficulties in communication. Will component disappear. The patient becomes apathetic.
Symptoms of cognitive nature are invisible and are often detected only as a result of neuropsychological tests. Cognitive schizophrenia symptoms include:
- The weakness of “managing functions”. There is a decrease of the ability to absorb and process information and make decisions based on this information;
- Inability to focus attention.
- Problems with “working memory” (the ability to remember recently received information and immediately apply it).
- Cognitive impairment often prevents a patient from leading a normal lifestyle and taking care of themselves. As a result, it can cause severe emotional distress.
Affective disorders (mood disorders) can manifest as a mania or depression. Depression is accompanied by a steady decline in mood, mental and motor retardation. Mania, on the other hand, is characterized by an increase in mood, excessive activity, loquacity and a reassessment of one’s own capabilities. Mood disturbances can occur with any form of schizophrenia. However, they are most vivid in the case of the hebephrenic form of the disease.
Separately, it is worth noting schizophrenia symptoms in men:
- social self-isolation;
- persecution mania;
- the appearance of “voices in the head.”
Symptoms of schizophrenia in women also have their own peculiarities of manifestations:
- persecution mania;
- frequent reflection;
- conflicts on the basis of social interests.
It is worthy of note that, in general, the symptomatology of schizophrenia in both sexes is practically the same while the manifestations of these symptoms can differ. In women, they often appear in the form of attacks, while in men the symptoms are continuous.
Schizophrenia Symptoms in Children
Among the main schizophrenia symptoms in children, we can distinguish the following:
- disorders of the motor spectrum;
Quite often, parents take these symptoms for the bright imagination of their child and, in general, as the peculiarities of the development. The establishment of an accurate diagnosis is possible only when referring to a specialist which, on the basis of the previously noted factor, is extremely rare. Meanwhile, a specialist can determine schizophrenia in a child from the age of two years.
Schizophrenia in Adolescence: Symptoms
The main manifestations, in this case, are the following:
- poor progress;
- severe forms of schizophrenia are accompanied by dementia.
Early Signs of Schizophrenia with the Gradual Onset of the Disease
Symptoms develop throughout the year and longer.
Unsociability, estrangement from the outside world, limiting contacts, striving for solitude.
Inexplicable internal anxiety.
Coldness towards relatives and friends. Indifference to their problems.
Unmotivated outbreaks of negativism, aggression.
Inadequate emotional response (laughter, joy in a sad, tragic situation, etc.).
The appearance of obsessive thoughts and actions, fears, discomfort in various parts of the body. Conviction of the presence of an incurable disease.
One of the first, early signs of schizophrenia is the loss of interest in hobbies, studies, work. At the same time, often there are new eccentric occupations – from reading philosophical literature and extrasensory to collecting something ridiculous.
Pointless reasoning. The use of new fictional words in speech, loss of thoughts, etc.
What Is the Outcome of Schizophrenia?
Schizophrenia is characterized by persistent violations of thinking, emotions, behavior, and other mental functions. Separation from the outside world and immersion in your own experiences, delusions and hallucinations, negativism and aggression, apathy and reasoning.
As a result, the disease gradually changes a patient’s personality, violates their social adaptation, often leading to a complete separation from reality, immersion in their own world of painful experiences.
However, no one can predict the outcome of schizophrenia.
Some people have only transient manifestations of the disease, occurring only a few times in life during an exacerbation. Approximately in 20-30% of patients with schizophrenia, the first signs of the illness appear acutely, quickly pass (within a month and a half), and do not repeat during life.
In others, the psychiatric disorder constantly takes place but it does not progress. This allows maintaining social contacts and work if the patient carries all the necessary medical measures out and strictly follows medical recommendations.
Sometimes a long chronic course of schizophrenia leads to a complete disorganization of the psyche and the loss of ability to work. As a result, the person becomes disabled and needs constant care.
According to statistics, almost 30% of patients with schizophrenia commit suicide.
It is important to immediately consult a qualified psychiatrist when the first signs of mental disturbance appear. An experienced specialist can quickly assess the patient’s condition, the presence and severity of mental and behavioral disorders (including the early signs of schizophrenia), the urgency and need for inpatient treatment.