Schizophrenia Symptoms

What Is Schizophrenia?

Schizophrenia is a serious mental disorder that can impact how a person feels, thinks, or behaves. Before being called schizophrenia, it was known as dementia praecox, a Latin word for mental deterioration.

Schizophrenia means the “splitting of psychic functions.” The term was coined by Eugen Bleuler in 1911. According to Bleuler, Schizophrenia is the split between the individual's emotional and cognitive experiences. For example, one suffering from schizophrenia can laugh for hours for no reason, or the patient may show no dismal when something goes wrong or if there is a piece of bad news.

Although schizophrenia is classified as a serious psychiatric illness, it affects roughly 1% of people of all races and cultures, usually starting in adolescence or early adulthood [¹]. Diagnosing mental disorders such as schizophrenia can be difficult as the symptoms can overlap with those of other mental disorders like bipolar disorder or multiple personality disorder[²]. Also, the symptoms of schizophrenia are diverse and complicated, and these symptoms may change with the progression of the mental disorder.

How Is Schizophrenia Diagnosed?

As mentioned earlier, it is difficult to diagnose mental disorders. Unlike other areas of medicine where one lab test can diagnose a person with any medical condition, mental disorders like schizophrenia demand high behavioral observation by the practitioner to be diagnosed.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), in order to diagnose a person with schizophrenia, a person must exhibit two of the following conditions for at least two months or more. These conditions include;

Delusions

Delusions are false beliefs. These beliefs are often very strong and can be difficult to shake, even when they are obviously not true.

In schizophrenia, there can be different types of delusions, including erotomanic, somatic, grandiose, and persecutory delusions [³]. The most common type of delusion is persecutory delusion. An example of a person experiencing a persecutory delusion may feel they are followed by someone or plotting against them.

Hallucinations

Hallucinations are perceptions of objects that are not genuinely there in the external environment. They can impair any five senses but are most typically connected with hearing voices or seeing objects that aren't there. Although there are five types of hallucinations, the most common ones are auditory and visual hallucinations [⁴]. For example, people who hallucinate might feel that something is crawling on their skin or someone is talking to them when no one is there.

Disorganized Speech

Disorganized speech is a characteristic of schizophrenia that involves difficulties organizing and articulating thoughts in a comprehensible manner. It might make it difficult for the person to express themselves effectively and make it challenging to follow or understand what they are saying. There can be many types of disorganized speech; a few examples include incoherence (illogical sentences), neologisms (made-up words and phrases), and tangentiality (shifting from one topic to another).

Weak or No Signs of Emotions

The flat effect is also known as the condition where a person does not show any emotion in the way that others would expect. The person may lack accurate body language and have no facial expressions or no tone of voice.

Disorganized behavior

Schizophrenia is characterized by disorganized behavior [⁵]. This includes being irrelevant or illogical, talking gibberish, making sentences that make no sense, awkwardly responding to internal stimuli, and more.

Schizophrenia Staging

Schizophrenia shows itself in three phases. Each phase has its own symptoms and can overlap with the other.

These include;

The prodromal phase
The active phase
The residual phase

Is Schizophrenia Hereditary?

Initially, the research suggested that the likelihood of developing schizophrenia in biological relatives is around 10% even if the child was adopted by a healthy family right after birth [⁷].

Later, it was shown that monozygotic twins have a greater prevalence rate for schizophrenia (45–50%) than dizygotic twins. The presence of schizophrenia in biological parents increases the chance of developing the illness, but not in adoptive parents [⁷]. The concordance rate for schizophrenia in monozygotic twins is significantly below 100%, indicating that experience-related variables considerably impact the onset of schizophrenia.

The research suggests that certain people have a genetic predisposition to developing schizophrenia, which may or may not be triggered by experience [⁷].

A wide variety of research also suggests that although there are many causes of schizophrenia, genes can be a risk factor, and over time many genes have been linked to the disorder. However, the exact mechanism of action of how these genes are responsible for causing schizophrenia is still yet to be studied.

Schizophrenia Symptoms

The symptoms of schizophrenia vary from person to person. These symptoms are categorized into three categories including;

Psychotic symptoms
Negative symptoms
Cognitive symptoms

What Are the Symptoms of Schizophrenia?

In order to understand the working of schizophrenia, researchers categorized its symptoms into three main categories.

Positive Symptoms

These are the experiences in a suffering person's thoughts, emotions, and behaviors. These symptoms are not present in any healthy individual. These include;

Delusions

Delusions are strong false beliefs with no evidence. Delusions have their further subtypes. A person suffering from schizophrenia may experience delusions like someone is following them or God is eating their good or more.

Hallucinations

Hallucinations are sensory experiences. A person suffering from schizophrenia may hear voices or see things that are not there. Hallucinations have their own subtypes the most common ones are auditory hallucinations.

Disorganized Thought or Speech

Disorganized thoughts are when a person with schizophrenia fails to explain his thought entirely. The person might shift from one topic to another or say things with no literal meaning.

Negative Symptoms

Negative symptoms include decreasing or losing regular actions linked to interest and motivation. Negative symptoms are a crucial aspect of schizophrenia. These are responsible for most of the disorder's long-term morbidity and patients' subpar functional outcomes [⁸].

These symptoms include the following;

Avolition

Avolition is a lack of motivation or difficulty starting and completing goal-directed activities. For example, a person may feel no interest or motivation when doing things he liked to do once.

Affective Flattening

It is a lack of emotional response. It can manifest as a lack of facial expressions, monotone speech, or decreased emotional responsiveness. For example, a person may show no strong emotions when needed.

Catatonia

Catatonia is the state of immobility. For example, a person may stay motionless for hours or in an awkward position for long periods.

Cognitive Symptoms

These symptoms refer to difficulties in thinking, problem-solving, and memory that can affect a person's ability to function in daily life.

Cognitive symptoms include the following;

Impaired Attention

A person with schizophrenia may find it difficult to focus.

Impaired Working Memory

Working memory is when a person can hold any information for a long time. A person with schizophrenia may have difficulty with this, affecting their ability to learn, reason, and problem-solve.

Impaired Social Cognition

It refers to when a person with schizophrenia fails to respond to social cues and may lose their ability to perceive, interpret and respond to interpersonal situations.

What Are Some Signs of Schizophrenia?

As soon as an individual notices these alarming symptoms that could indicate schizophrenia, it is essential to discuss the problem with the doctor, who can run helpful tests. Unlike many medical conditions, no one test can diagnose a person with schizophrenia.

In order to diagnose a person with this mental disorder, the process includes a physical exam, a medical history exam, and many psychological assessments.

Schizophrenia, signs, and clinical manifestations include:

Psychological Assement

This assessment includes the observation of symptoms related to schizophrenia. These symptoms include;

Positive symptoms (including hallucinations, delusions, and disorganized speech and thought).
Mood symptoms (extreme depression and anxiety).
Negative symptoms (catatonia, flat affect, and avolition)
Cognitive symptoms (impaired working memory, impaired attention)
Medical Exams and Medical history

This exam takes care of the medical history of the patient and looks for any biological symptoms. It usually includes blood tests and neuroimaging tests. These tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, may be done to rule out any structural abnormalities in the brain that could be causing the person's symptoms.

Diagnostic and Statistical Manual of Mental Disorders Criteria

The American Psychiatric Association created a set of diagnostic standards that are used to identify mental illnesses like schizophrenia.

Symptoms of Schizophrenia in Women vs. Symptoms in Men

According to the research, there are major sex differences in schizophrenia. Men with schizophrenia exhibit more negative symptoms.

Negative symptoms are those symptoms that involve a decrease or absence of normal behavior and thoughts. Men with schizophrenia are more likely to experience social withdrawal, which can make it difficult for them to interact with others and form relationships. They may also have blunted or incongruent effects, which means that their emotional responses may not match the situation they are in.

In contrast, women are more likely to show affective symptoms. Affective symptoms involve changes in mood and emotion. Women also exhibit more mood disturbance and depressive symptoms, such as feelings of sadness, hopelessness, and loss of interest in activities they once enjoyed. One possible reason for these differences could be related to hormonal changes [⁸].

Risk Factors for Schizophrenia

The exact cause of schizophrenia is still unknown. A high amount of research suggests that the following factors can be a major cause for triggering schizophrenia in many individuals. These factors include;

Family history of mental disorders.
Pregnancy and birth complications.
Taking psychoactive and psychotropic drugs.
Genetic predisposition.
Obstetric complications during birth.
Childhood trauma or abuse.
Advanced paternal age.
Neurodevelopmental disorders.
Brain damage or immature brain development.

Schizophrenia Prevention

Because there are no know exact causes of schizophrenia, it can be difficult to pinpoint any preventative technique.

Following are some measures that may help to reduce the risk of developing schizophrenia.

Early intervention can help. It is important to seek psychiatric help If you or any of your loved ones are experiencing symptoms of schizophrenia or other mental health disorders.
Regular sleep, managing stress, and a proper diet can help you prevent any mental disorder, including schizophrenia.
Pregnant women should also receive regular prenatal care and avoid exposure to infections.

Prognosis And Treatment of Schizophrenia

The prognosis for individuals with schizophrenia can vary widely depending on the severity of symptoms, their response to treatment, and their ability to maintain treatment over time. It is important to note that the early the treatment starts, the better the prognosis

Because this is a mental disorder and there is a high chance of relapse, some individuals with schizophrenia may continue to experience symptoms and require ongoing support.

Schizophrenia Survival Rate

According to the statistics, around 50% of people with schizophrenia recover and return to their daily lives with no symptoms. Around 25% recover but still need medical and psychiatric assistance to function normally. While 15% of the patients suffering from schizophrenia do not get better are need immediate hospitalization [⁹]

Schizophrenia Treatment Options

The treatment options for schizophrenia include the following;

Antipsychotic medications
Cognitive behavioral therapy (CBT)
Case management
Electroconvulsive therapy (ECT)

Conclusion

Takeaway

Schizophrenia is a chronic mental disorder that can impact our daily lives. However, it has many risk factors and can be triggered easily in people with a family history of disorders. But certain protective measures can decrease the chances of schizophrenia. Contacting your doctor as soon as you observe any abnormal signs in your behavior is essential to increase the survival rates.