Schizophrenia belongs to severe mental disorders leading to the distorted perception of reality. The affected person is acting inadequately, and their ideas and explanations are illogical (thought disorder).
The scientific views on the causes of schizophrenia remain a controversial position. The underlying risk factor is heredity, secondary factors – various diseases and traumas. They are triggering the latent processes. The first signs of schizophrenia are diagnosed, as a rule, in adolescence. This mental disorder is more common among youngsters and less widespread among elderly people. Nowadays almost 1% of the world’s population is familiar with it.
The loss of social contacts, emotional dullness, passive attitude, delusion, compulsive, thought, and motor disorders, uncharacteristic for the person irritability or aggressiveness – all these are signs of endogenous psychosis.
Though some people call this mental disorder a “dual personality”, in fact, the root of schizophrenia lies in splitting mental functions. The patients are disorganized and act irrationally. Regardless of their intelligence, their reasoning and behavior are inadequate. There is no accordance between the person’s potential and its fulfillment.
The diagnosis “schizophrenia” causes a lot of contradictory discussions among scientists. In some countries, only severe manifestations of this disorder entail the conclusion of schizophrenia, in others any symptoms of this pathology lead to such a diagnosis. The course of the mental illness can also be quite different: from a single manifestation to a chronic process. During remission, a person can be perfectly capable and has no differences from healthy people.
Signs and symptoms
Experts approach diagnosing schizophrenia very carefully. They examine the whole range of disorders: emotional and neurotic.
Emotional signs of schizophrenia:
- Emotional dullness – the person becomes indifferent to their family.
- Inadequacy – in particular cases, the patient is hypersensitive to certain stimuli: a mere trifle can cause unmotivated aggression, anger, jealousy. And those who are closest to the patient are first to suffer. The less close the person is to someone, the less pronounced the negative reaction is. The attitude to strangers will hardly change.
- The loss of interest in usual activities.
- The dullness of sensations – reduced instinctive needs, such as appetite, hygiene.
- Delusion – distorted perception of reality. The patient sees unusual, colored dreams, is obsessed by the idea that someone is watching them, wants to kill them, is affecting them in some way, etc. Often, the affected person believes that their spouse cheats on them. Unlike “normal” jealousy, such delusions take the form of obsessive thoughts.
- Hallucinations – the most common are auditory hallucinations: the person hears the voices telling them what to do, controlling them. The patient also can have visual colored hallucinations, such as bright dreams.
While it’s hard to notice mild emotional disorders in early stages, delusion and hallucinations are impossible to miss. They are characteristic symptoms of schizophrenia. You can assume other emotional disorders in families where bouts of jealousy, fights, aggression, depressive disorders happen quite often. And schizophrenia is last of all here. But if the family relationship is fine, irrational behavior and thought disorders are spotted at once.
The signs of schizophrenia can be neurotic. The most widespread of them are depersonalization, phobias, anxiety, hypochondria, catatonic stupor or, on the contrary, excitation. Their manifestations are peculiar: the patient can complain about the sensation of blood flowing inside, unusual phobias, such as, for example, the fear of books. The ill person can tell about the details of their most absurd phobias in an even voice, see unusual colored dreams.
The main symptoms of schizophrenia
The symptoms of schizophrenia divide into three categories: positive, negative, and cognitive.
Its positive symptoms include:
- Mental confusion – irrational thoughts, absentmindedness. The patient forgets what they need this or that thing for or can’t complete their thought. In order to solve the problem, the brain activates abstract or symbolic thinking.
- Blurring the borderline between imagination and reality (derealization). There are three variants of the DR: during the initial stage, the ill person “loses identity” and thinks they are “swallowed” by the world. The patient can have a sudden idea of being tied by blood to unknown people and deny their real family relationship. The perception of the external world is altered: the colors seem too bright, an ordinary object acquires peculiar properties.
The negative symptoms of schizophrenia:
- Sluggishness – the patient loses the ability to quickly react and make decisions, can’t keep the conversation going.
- “Flat” emotions – reduced expression of emotions: poor facial expressions and voice tone. Speech is monotonous, gesticulation nonexistent.
- Isolation – the person has difficulties in social situations. They are not able to meet new people and lose touch with their old friends. This symptom reminds an autistic disorder to an extent. Perhaps, that’s why doctors used to consider autistic people schizophrenics once.
- Difficulties with concentration, which make it impossible for the person to lead their usual lifestyle, go to work, maintain favorite activities. Even the handwriting becomes twisted.
- Total loss of interest in what’s happening around. Instead, there are obsessive thoughts. Productive life becomes unreal.
The negative symptoms of schizophrenia in general lie in the loss of life force, which entails the impossibility to function as a complete individual.
Schizophrenia: cognitive symptoms
The cognitive symptoms of schizophrenia affect the memory, attention, and thinking. All this is disrupted to some extent. The ill person can’t focus and perceive new information. Cognitive impairments include:
- Garbled speech – conversations become abstract, full of symbols and neologisms, vocabulary poor. Sometimes breaks in speech, repetitions, and illogical rhymes are possible.
- Memory problems.
Cognitive impairments are resistant to treatment with traditional antipsychotic drugs. To the contrary, the side-effects of these drugs only make the situation worse.
Cognitive impairments have a negative influence on the person’s everyday life. Social, professional, household duties become hard to carry out.
Hallucinations and schizophrenia
Hallucinations, delusion, obsessive thoughts are characteristic for paranoid schizophrenia.
Hallucinations are the person’s own imaginary world projected upon the real one. This imaginary world has its bright-colored depictions of reality and voices that speak inside of the patient’s head. Hallucinations can involve one or a few sense organs. Wrong visual, auditory, tactile, olfactory, and taste perception is what’s characteristic of this mental disorder.
It’s customary to divide the hallucinations into two groups: true and false. What’s the difference? “True” hallucinations mean that the person hears voices in a real room or sees pictures on a real flat surface. “False” hallucinations happen entirely inside of the patient’s head.
False perception can be basic and complex. In the first case, it’s separate sounds and noises. In the second – the imagination is constructing very bright colorful visions. Here are the symptoms of hallucinations:
- The person is talking to themselves when they are alone;
- Changed behavior during conversations: the patient is acting as though they are listening to inner voices;
- Laughing for no reason;
- Anxiety and detachment during the conversation.
Hallucinations can be autoscopic. In this case, the ill person sees a doppelganger.
If one of your loved ones is suffering from perception and thinking impairments, it’s forbidden to discuss their obsessions, support their false claims or persuade the person that what they see and hear is unreal. Don’t make fun of the patient!
Patients with schizophrenia often suffer from delusions. Delusion is an imaginary concept of the external world. The cause of this problem lies in the processes taking place inside the patient’s mind. Information doesn’t influence them. They are exclusively the result of the impaired consciousness. The most widespread delusion is persecution mania. In this case, the patient starts suspecting that their family and friends have evil intentions towards them. The affected person often has constant urges to send complaints to various authorities in order to punish “the guilty”. At the same time, the person is suffering from the twisted feeling that everyone is mocking them. If obsessive thoughts are hypochondriac by their nature, the patient will be bothering every doctor in the area, looking for nonexistent diseases.
How would you know if the person has delusions characteristic of schizophrenia? It’s easy to notice delusions which are imaginary in essence. But when they are plausible, the task becomes much more difficult. For example, it’s hard to diagnose pathological jealousy.
The delusion of self-flagellation represents a particular danger when the patient slips into a depression and all their thoughts are aimed at blaming themselves. Such a disorder is often accompanied by insomnia. At this stage, the patient can attempt to commit suicide. Serious crimes, such as mass murders, are also quite often caused by schizophrenia. Such criminals may later deny the reality of their wrongdoings and think of them as colored dreams.
Experts have summed up a few tips on how to detect schizophrenic delusions. Watch the following signs:
- Changes in behavior, unprovoked aggression;
- Constant fantasizing, colored dreams;
- Unreasonable fear for one’s own life and health;
- The manifestations of fear in the form of voluntary confinement, social phobia;
- Sending complaints to the authorities without a proper reason.
Psychiatrists recommend that you don’t argue with schizophrenics about their beliefs. If the patient expresses violent emotions (anger, fear, sadness) – contact an expert immediately.
Aggression in people who have schizophrenia
By the word “aggression” we understand human behavior which is aimed at doing other human beings moral or physical harm. In everyday life, healthy people can also experience fits of anger as a defense reaction to an external irritant. But schizophrenia makes aggression an impulsive reaction rather than self-defense. Aggression is triggered by thought disorder and a wrong interpretation of reality. Nervous agitation, insomnia, negative attitude to other people, unmotivated distrust – all these symptoms make schizophrenia a valid assumption.
Statistically, men diagnosed with schizophrenia show aggression 6 times more often than mentally healthy men. The situation among women is even more upsetting: schizophrenic women demonstrate aggressive behavior 15 times more often than healthy ladies. Pathological jealousy is also more common among women. However, some experts admit that aggression fits are more widespread among alcoholics than among schizophrenics. This makes it possible to draw a conclusion that some people have a genetic predisposition to such behavior, and mental disorders are only catalysts of its development.
The presence of certain symptoms increases the risk of aggression. If the patient is suffering from the delusion of persecution, hallucinations, organic brain damage, pathological jealousy, is inclined to antisocial or criminal behavior and alcohol abuse – they have a greater chance of joining aggressive schizophrenics. That’s especially true for the “drinking” patients because alcohol negatively affects cognitive processes and brings the inadequate reaction to external stimuli. Such a person can even kill their partner during a fit of jealousy.
Aggression often accompanies paranoid schizophrenia. In this case, internal causes of the disorder can become catalysts even without any external irritants. If the affected person is prone to impulsiveness and restlessness, aggression can acquire threatening nature. At this stage, the patient needs hospitalization because there is a high risk of unprovoked dangerous actions.
Motor disorders in schizophrenics
Motor disorders manifest as strong excitation or stupor. In the first case, the patients are restless, prone to nonsensical exclamations which often contain rhymes, repetitions, and mimicry. Restlessness is alternating with periods of indifference, the flow of speech – with the sudden silence.
During catatonic excitation the patients can show aggression to others, sometimes they represent a mortal danger. They don’t react to speech addressed to them because their thoughts are in disarray, perception impaired. Only medications can help to cope with the attack. The problem is, the patients often enter excitation phase at night (when they see colored dreams or can’t sleep), and after a few hours, it reaches its peak. That’s why people close to the patient should learn to react to the attacks properly and fast enough.
Catatonic stupor is completely different. There is no restlessness: the patient freezes in place. Increased muscle tone is characteristic of such a condition. But there is a possibility that the person stays in a flexible pose for a long time. They don’t react to people around, stop eating, is focusing on one point. If you attempt to force them into another position you’ll be successful: there is no resistance. Sometimes there are bouts of negativity when the person reacts in the negative to the outside world. Their mind remains susceptible to human speech but they refuse to talk.
Schizophrenia is a mental disorder which requires careful diagnosing. According to global mental health ethics, the examination should be inclusive and meet a number of criteria. First of all, the psychiatrist is collecting initial data. They include an interview in order to detect the initial signs of schizophrenia, investigate the complaints and developmental characteristics.
Diagnosing schizophrenia also includes the following main aspects:
- Passing specific psychological tests. They are informative for initial stages of the disorder and borderline state.
- Tomography helps to detect organic disorders (tumors, hemorrhages, encephalitis) which could have an effect on the patient’s behavior. A lot of symptoms characteristic of schizophrenia can be caused by organic brain disorders.
- It’s useful in diagnosing head injuries and brain diseases.
- Laboratory diagnosis: urine test, blood biochemistry, immunogram, hormones.
In order to make out a correct diagnosis, experts can implement additional examinations: sleep study tests, vascular screening, and viral tests.
Health professional makes out an eventual diagnosis only if the patient has been showing the symptoms of schizophrenia for more than six months. At least one clear and two vague signs should be present:
- Thought disorder when the person is convinced that their thoughts don’t really belong to them or are in fact not theirs at all.
- The impression of outside influence: the patient believes that someone is controlling their actions.
- Distorted perception of speech or actions.
- Hallucinations: auditory, olfactory, tactile, and visual.
- Obsessions (for example, delusional jealousy).
- Mental confusion, motor disorders: stupor of excitation.
Though medical experts use comprehensive diagnostics, every tenth diagnosis is wrong – that means it’s very difficult to delineate the pathology.
Schizophrenic disorders can pass favorably provided they’ve been noticed in time and treated. If schizophrenia manifested in adulthood, it responds to treatment better. Childhood schizophrenia is the most difficult to treat. It belongs to malignant type. It should also be noted that men show the signs of schizophrenia more often than women; it can be explained by the specifics of the female psyche.
According to researches, sudden psychomotor symptoms are easier to correct than the protracted development of the initial signs. A favorable outcome depends on the time of the first consultation with an expert and proper therapy.