What is schizophrenia?
• A chronic severe brain disorder; often they
hear voices, believe media are broadcasting
their thoughts to the world or may believe
someone is trying to harm them.
• In men it usually develops in teen years and
early 20s; in women it usually develops in 20s
• Currently there is no physical or lab test that
can absolutely diagnose schizophrenia.
• A psychiatrist usually comes to the diagnosis
based on clinical symptoms.
• This is a common problem since schizophrenia
shares a significant number of symptoms with
• Per the Nat’l Depression & Bipolar Support
Alliance there is an average of 10 years from
onset to correct diagnosis & tx.
Disorders that may appear like
• Schizoid personality
• Schizophreniform disorder
• Schizotypal personality
• Bipolar Disorder
• Asperger’s syndrome
Symptoms of Schizophrenia
• Profound disruption in cognition and
emotion, affecting the most fundamental
– Sense of self
• Positive symptoms are those that have a
positive reaction from some treatment.
• In other words, positive symptoms respond to
• Those that appear to reflect an excess or
distortion of normal functions.
• Delusions. Those where the patient thinks he
is being followed or watched are common;
also the belief that people on TV, radio are
directing special messages to him/her.
Hallucinations. Distortions or exaggerations of
perception in any of the senses.
Often they hear voices within their own thoughts
followed by visual hallucinations
• Disorganized thinking/speech.
• AKA loose associations; speech is
tangential, loosely associated or incoherent
enough to impair communication.
• Grossly disorganized behavior.
• Difficulty in goal directed behavior
(ADLs), unpredictable agitation or silliness, social
disinhibition, or bizarre behavior.
• There is a purposelessness to behavior
• Catatonic behavior.
• Marked decrease in reaction to immediate
environment, sometimes just unaware of
surroundings, rigid or bizarre postures, aimless
• Other Positive Symptoms:
• Inappropriate response to stimuli
• Unusual motor behavior (pacing, rocking)
• Somatic preoccupations
• Those that appear to reflect a diminution or
loss of normal functions.
• May be difficult to evaluate because they are
not as grossly abnormal as positive symptoms.
• Affective flattening.
• Reduction in the range and intensity of
emotional expression, including facial
expression, voice tone, eye contact and body
• Alogia (poverty of speech)
• Lessening of speech fluency and
productivity, thought to reflect slowing or
blocked thoughts; often manifested as
short, empty replies to questions.
• The reduction, difficulty or inability to initiate
and persist in goal-directed behavior. Often
mistaken for apparent disinterest.
Examples of Avolition
• No longer interested in going out with friends
• No longer interested in activities that the person
used to show enthusiasm
• No longer interested in anything
• Sitting in the house for hours or days doing
• This one is somewhat new and may not be
• It is thought disorder, confusion, disorientation
and memory problems.
• Summary of Negative Symptoms
Lack of emotion
Lack of interest in life
Inappropriate social skills
Inability to make friends
• Difficulties in concentration and memory:
– Disorganized thinking
– Slow thinking
– Difficulty understanding
– Poor concentration
– Poor memory
– Difficulty expressing thoughts
– Difficulty integrating thoughts, feelings, behaviors
Currently there is no treatment that has a
consistent impact on negative symptoms
• Persons are very suspicious of others and often
have grand schemes of persecution at the root
of their behavior.
• During this phase they may have
hallucinations and frequent delusions.
• AKA disorganized schizophrenia; characterized by
emotionless, incongruous, or silly
behavior, intellectual deterioration, frequently
beginning insidiously during adolescence.
• May be verbally incoherent and may have moods and
emotions that are not appropriate to the situation.
• Hallucinations not usually present.
• Person is extremely withdrawn, negative and
• May have marked psychomotor disturbances.
• Lacks motivation and interest in day-to-day
• Person is not usually having
delusions, hallucinations or disorganized
• There will be symptoms of schizophrenia as
well as mood disorder
(depression, bipolar, mixed mania).
• Conditions meeting the general diagnostic
criteria for schizophrenia but not conforming
to any of the previous types.
• Exhibits more than one of the previous types
without a clear dominance of one.