Schizophrenia

    Hallucinations. A hallucination is something a person sees,
    hears, smells, or feels that no one else can see, hear, smell, or feel.
    “Voices” are the most common type of hallucination in schizophrenia.
    Many people with the disorder hear voices that may comment on their
    behavior, order them to do things, warn them of impending danger, or
    talk to each other (usually about the patient). They may hear these
    voices for a long time before family and friends notice that something
    is wrong.1
    Other types of hallucinations include seeing people or objects that are
    not there, smelling odors that no one else detects (although this can
    also be a symptom of certain brain tumors), or feeling things like
    invisible fingers touching their bodies when no one is close by.

    Delusions. Delusions are false personal beliefs that are not
    part of the person’s culture and do not change, even when other people
    present proof that the beliefs are not true or logical. People with
    schizophrenia can have delusions that are quite bizarre, such as
    believing that neighbors can control their behavior with magnetic waves,
    people on television are directing special messages to them, or radio
    stations are broadcasting their thoughts aloud to others. They may also
    have delusions of grandeur and think they are a famous historical
    figure. People with paranoid schizophrenia can believe that others are
    deliberately cheating, harassing, poisoning, spying upon, or plotting
    against them or the people they care about. These beliefs are called
    delusions of persecution.

    Thought Disorder. People with schizophrenia often have
    unusual thought processes. One dramatic form is disorganized thinking
    where the person may have difficulty organizing his thoughts or
    connecting them logically. Speech may be garbled or hard to understand.
    Another form is “thought blocking” where the person stops abruptly in
    the middle of a thought. When asked sometimes the person says it felt as
    if the thought had been taken out of his head. Finally, the individual
    might make up unintelligible words, so-called “neologisms.”

    Disorders of Movement. People with schizophrenia can be
    clumsy and uncoordinated. They may also show involuntary movements and
    may show grimacing or unusual mannerisms. They may repeat certain
    motions over and over or, in extreme cases, may become catatonic.
    Catatonia is a state of immobility and unresponsiveness that was more
    common when treatment for schizophrenia was not available; fortunately,
    it is now rare.2, 3

    Negative symptoms

    The term “negative symptoms” refers to reductions in normal emotional and behavioral states. These include:

    • flat affect (immobile facial expression, monotonous voice),
    • lack of pleasure in everyday life,
    • diminished ability to initiate and sustain planned activity, and
    • speaking infrequently, even when forced to interact.

    People with schizophrenia often neglect basic hygiene and need help
    with everyday living activities. Because it is not as obvious that
    negative symptoms are part of a psychiatric illness, people with
    schizophrenia are often perceived by others as lazy and not willing to
    better their lives.

    Cognitive symptoms

    Cognitive symptoms are subtle and are often detected only when neuropsychological tests are performed. They include:

    • poor executive functioning (the ability to absorb and interpret information and make decisions based on that information),
    • inability to sustain attention, and
    • problems with working memory (the ability to keep recently learned information in mind and

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