Schizophrenia Symptoms

  • Symptoms

    The symptoms of schizophrenia are highly variable Table 01. If you have schizophrenia, you may behave differently at different times, and experience psychotic episodes that come and go. Symptoms generally appear in men in their teens or early twenties, whereas women generally experience their first symptoms in their twenties or thirties.

    Symptoms of schizophrenia are classified as being positive or negative. Positive symptoms are defined as those that would not occur normally in the general population, and include such things as psychosis, hallucinations, and delusions. Psychosis is a state of being out of touch with reality, or the inability to separate reality from fantasy. Hallucinations occur when you sense something that does not exist (such as hearing imaginary voices). Delusions are beliefs that are not based in reality, such as feelings of being persecuted or conspired against.

    Negative symptoms are defined as a lack of behaviors that would normally occur in society. Negative symptoms include dulled emotions, reduced speech, and extreme lack of motivation and drive. Negative symptoms are among the most common and debilitating symptoms of schizophrenia. These symptoms are most often associated with a poor long-term outcome and poor response to medication.

    Table 1.  Symptoms of Schizophrenia

    Positive symptoms
    Delusions Hallucinations Bizarre speech/thought processes
    Paranoid Auditory Loosening of associations or derailed thinking (when your thought processes go "off the track")
    Grandiose Visual
    Religious Olfactory
    Somatic Somatic
    Sexual Tactile
    Referential (thinking that things,like what you see and hear on the TVor radio refer to you specifically)
    Negative symptoms
    ?Poverty of speech Social isolation ?Other
    Reduced amount of speech Disinterest Self?neglect
    Reduced content Poor rapport Lack of interests
    Reduced tone Lack of motivation
    Cognitive deficits
    Trouble paying attention
    Memory loss
    Lowered judgment
    Trouble planning
    Other symptoms
    Suicidal thinking and behavior
    Movement abnormalities or catatonia
    Social difficulties
    Educational difficulties
    Work difficulties

    Your symptoms will depend on the type of schizophrenia you have: paranoid, disorganized, catatonic, residual, or undifferentiated. Paranoid schizophrenia is dominated by delusions and hallucinations, but exhibits few negative symptoms and little cognitive impairment. Disorganized schizophrenia is dominated by extremely disorganized thinking, speech, and behavior. Catatonic schizophrenia is very rare, and is characterized by episodes of prolonged speechlessness and lack of movement.

    Residual schizophrenia is characterized by negative symptoms in the absence of positive symptoms.

    Undifferentiated schizophrenia occurs when none of the above categories apply. Undifferentiated schizophrenia is the most common subtype, followed by the paranoid subtype.

  • Risk Factors

    Having a family history of schizophrenia is a risk factor for developing the disease Table 02. Family studies show that there is a genetic component to schizophrenia. You have a greater chance of developing schizophrenia if a first-degree relative such as a parent or sibling also has the disease.

    Table 2.  Percent Risk of Developing Schizophrenia

    Family member(s) with schizophrenia Percent chance child will develop schizophrenia
    Both parents 46%
    Sibling and one parent 17%
    One parent 13%
    One sibling 10%
    Identical twin 50%
    Fraternal twin 20%

    Some inconclusive studies have revealed that children who exhibit certain behaviors are more likely to develop schizophrenia as adults. According to these studies, children with delayed motor milestones, neurological deficits, lower IQ, attention, and related cognitive difficulties, and impaired social and scholastic achievement have been found more likely to develop adult schizophrenia than children without these traits.

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