Schizophrenia: Symptoms

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Symptoms

Symptoms of schizophrenia are divided into two groups: negative and positive.

Negative symptoms include:

• Inability to experience pleasure. This is a common symptom in schizophrenia and includes difficulty enjoying activities that once brought pleasure, such as playing golf or visiting with friends.
• Lack of emotion. This can lead to few friendships or social contacts. Showing little facial expression, having poor eye contact, and slowed speech are characteristic.
• Loss of motivation to succeed or accomplish goals. Job or school performance problems are common.
• Problems focusing or paying attention, difficulty processing information, confusion, and fragmented thoughts.
• Self-neglect, such as poor hygiene, wearing dirty clothes, or neglecting living space until it becomes untidy or cluttered.

Negative symptoms usually occur first and can be confused with other health problems such as depression or substance abuse. Substance abuse often occurs before the symptoms of schizophrenia become apparent.⁶

Positive symptoms include:

• Hallucinations. These usually involve hearing noises or voices, but they can involve all the senses—seeing, tasting, touching, hearing, or smelling something that is not there.
• Delusions. These are firmly held but false beliefs. Some common experiences include thinking you are a powerful person, or that you are being persecuted or chased by the police or by demons.
• Disordered (confused) thinking and speech that does not make any sense. Examples include inappropriate responses to questions, not being able to respond with enough information, or always giving a one-word reply to questions.
• Bizarre or disorganized behavior. Usually the behavior involves being overly excited, angry, or unresponsive to other people. It may also include bizarre body movements, such as rocking back and forth or grimacing repeatedly.
• Inappropriate emotions, such as smiling when speaking of sad topics or laughing for no reason.

Some people with schizophrenia also have unusual symptoms, such as jerking eye movements.

Other symptoms can occur, depending on the type of schizophrenia you have:

• Paranoid schizophrenia causes unreasonable fears due to misinterpretations of what is going on around you.
• Catatonic schizophrenia causes peculiar behaviors such as standing in an awkward position for long periods of time.
• Disorganized schizophrenia causes unusual speech and behavior, such as making up words or constantly rhyming words.

Symptoms of schizophrenia usually emerge during adolescence or early adulthood and may appear suddenly or develop gradually. When symptoms develop gradually, they may be misdiagnosed with other conditions with similar symptoms, such as bipolar disorder or substance abuse (which commonly occurs with schizophrenia).

Last updated:	February 05, 2008
Author:	Jeannette Curtis
Reviewed By:	Kathleen Romito, MD - Family Medicine, Lisa S. Weinstock, MD - Psychiatry
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC