What is schizophrenia?

Schizophrenia is a serious mental health condition that causes disordered ideas, beliefs and experiences. In a sense, people with schizophrenia lose touch with reality and do not know which thoughts and experiences are true and real and which are not.

Some people have wrong ideas about schizophrenia. For instance, it has nothing to do with a split personality. Also, the vast majority of people with schizophrenia are not violent.

You should be aware that some people feel that schizophrenia should be abolished as a concept. They believe that the term is unscientific, stigmatising and does not address the root causes of serious mental distress. However, many members of the medical profession still find the term schizophrenia useful.

Schizophrenia develops in about 1 in 100 people. It can occur in men and women. The most common ages for it first to develop are 15-25 in men and 25-35 in women.

What are the symptoms of schizophrenia?

There are many possible symptoms. They are often classed into positive and negative. Positive symptoms are those that show abnormal mental functions. Negative symptoms are those that show the absence of a mental function that should normally be present.

Positive symptoms include the following

  • Delusions. These are false beliefs that a person has and most people from the same culture would agree that they are wrong. Even when the wrongness of the belief is explained, a person with schizophrenia is convinced that they are true. For example, a person with schizophrenia may believe that neighbours are spying on them with cameras in every room, or a famous person is in love with them, or that people are plotting to kill them, or there is a conspiracy about them. These are only a few examples and delusions can be about anything.
  • Hallucinations. This means hearing, seeing, feeling, smelling, or tasting things that are not real. Hearing voices is the most common. Some people with schizophrenia hear voices that provide a running commentary on their actions, argue with them, or repeat their thoughts. The voices often say things that are rude, aggressive, unpleasant, or give orders that must be followed. Some people with schizophrenia appear to talk to themselves as they respond to the voices. People with schizophrenia believe that the hallucinations are real.
  • Disordered thoughts. Thoughts may become jumbled or blocked. Thought and speech may not follow a normal logical pattern. For example, some people with schizophrenia have one or more of the following:
  • Thought echo. This means the person hears his or her own thoughts as if they were being spoken aloud.
  • Knight's-move thinking. This means the person moves from one train of thought to another that has no apparent connection to the first.
  • Some people with schizophrenia may invent new words (neologisms), repeat a single word or phrase out of context (verbal stereotypy), or use ordinary words to which they attribute a different, special meaning (metonyms).

Symptoms called disorders of thought possession may also occur. These include:

    • Thought insertion. This is when someone believes that the thoughts in their mind are not their own and that they are being put there by someone else.
    • Thought withdrawal. This is when someone believes that thoughts are being removed from their mind by an outside agency.
    • Thought broadcasting. This is when someone believes that their thoughts are being read or heard by others.
    • Thought blocking. This is when there is a sudden interruption of the train of thought before it is completed, leaving a blank. The person suddenly stops talking and cannot recall what he or she has been saying.

 

Negative symptoms include the following

  • Lack of motivation. Everything seems an effort - for example, tasks may not be finished, concentration is poor, there is loss of interest in social activities and the person often wants to be alone.
  • Few spontaneous movements and much time doing nothing.
  • Facial expressions do not change much and the voice may sound monotonous.
  • Changed feelings. Emotions may become flat. Sometimes the emotions may be odd, such as laughing at something sad. Other strange behaviours sometimes occur.

Negative symptoms can make some people neglect themselves. They may not care to do anything and appear to be wrapped up in their own thoughts. Negative symptoms can also lead to difficulty with education, which can contribute to difficulties with employment. For families and carers, the negative symptoms are often the most difficult to deal with. Persistent negative symptoms tend to be the main cause of long-term disability.

Families may only realise with hindsight that the behaviour of a relative has been gradually changing. Recognising these changes can be particularly difficult if the illness develops during the teenage years when it is normal for some changes in behaviour to occur.

Other symptoms

Other symptoms that occur in some cases include difficulty planning, memory problems and obsessive-compulsive symptoms.