The symptoms of schizophrenia vary between individuals and can be classified as positive and negative symptoms.

Positive symptoms

 

Positive symptoms are associated with acute schizophrenia and can be characterised by an excess or an alteration of sensory experiences, ideas or behaviour.

Hallucinations

These are perceptions that occur in the absence of an external stimulus, which are impossible to differentiate from reality. The hallucinations can involve any of the five senses:



• Auditory (sound)
• Visual (sight)
• Olfactory (smell)
• Tactile (touch)
• Gustatory (smell)

 

Auditory hallucinations are the most common and consists of voices which can be heard. The voices are often familiar and friendly; however, they are commonly abusive, offensive, critical or irritating. They may instruct the person to do things or discuss the person’s actions, behaviour and thoughts.Furthermore, the voices may talk to each other or can appear from several places or a single place in particular i.e. , the television. Visual hallucinations occur less frequently and regularly occur with the other forms of hallucinations.


Delusions

These are characterised by firmly held beliefs regardless of the conflicting evidence. These may include



• Delusions of control, in which the person has a strong belief that their behaviour, thoughts or emotions are being controlled by an outside force. Delusions of control can consist of thought insertion, withdrawal or broadcasting.
• Delusions of persecution, where they may believe people are watching, following or plotting against them.
• Delusions of grandeur, where the person has beliefs of having supernatural powers and self importance.
• Delusions of reference,  whereby the person believes that normal objects, events, or the actions of other people has a significant importance particularly for themselves.



Thought disorder: This comprises an impaired ability to process thoughts and is characterised by disorganised speech. The difficulty experienced in speech and thought may make conversations complicated and confusing for other people to comprehend.



Negative symptoms

 

In comparison to the ‘positive’ symptoms associated with acute schizophrenia, the chronic condition is characterised by negative symptoms. The negative symptoms can cause a reduction or absence of normal function. The symptoms include emotional blunting i.e.,  reduced eye contact, lack of facial expressions or a flat voice. Furthermore, it can include a lack of motivation, concentration and initiative. In addition, negative symptoms can also consist of apathy, social withdrawal, decreased or abnormal speech, reduced movement and self neglect. Cognitive impairment can also occur which includes deficiencies in abstract reasoning and in memory.

Lack of insight

 

Schizophrenic individuals are frequently unaware of their condition to a degree to which they consider themselves not ill.