Symptoms of schizophrenia

Symptoms

Self-portrait of a person with schizophrenia, representing that individual's perception of the distorted experience of reality in the disorder

Individuals with schizophrenia may experience hallucinations (most reported are hearing voices), delusions(often bizarre or persecutory in nature), and disorganized thinking and speech. The last may range from loss of train of thought, to sentences only loosely connected in meaning, to speech that is not understandable known as word salad. Social withdrawal, sloppiness of dress and hygiene, and loss of motivation and judgment are all common in schizophrenia.^[10] There is often an observable pattern of emotional difficulty, for example lack of responsiveness.^[11] Impairment in social cognition is associated with schizophrenia,^[12] as are symptoms ofparanoia. Social isolation commonly occurs.^[13] Difficulties in working andlong-term memory, attention, executive functioning, and speed of processingalso commonly occur.^[4] In one uncommon subtype, the person may be largely mute, remain motionless in bizarre postures, or exhibit purposeless agitation, all signs of catatonia.^[14]About 30 to 50% of people with schizophrenia fail to accept that they have an illness or their recommended treatment.^[15] Treatment may have some effect on insight.^[16] People with schizophrenia often find facial emotion perception to be difficult.^[17]

People with schizophrenia may have a high rate of irritable bowel syndromebut they often do not mention it unless specifically asked.^[18]

Positive and negative

Schizophrenia is often described in terms of positive and negative (or deficit) symptoms.^[19] Positive symptoms are those that most individuals do not normally experience but are present in people with schizophrenia. They can include delusions, disordered thoughts and speech, and tactile, auditory, visual,olfactory and gustatory hallucinations, typically regarded as manifestations ofpsychosis.^[20] Hallucinations are also typically related to the content of the delusional theme.^[21] Positive symptoms generally respond well to medication.^[21]

Negative symptoms are deficits of normal emotional responses or of other thought processes, and are less responsive to medication.^[10] They commonly include flat expressions orlittle emotion, poverty of speech,inability to experience pleasure, lack of desire to form relationships, and lack of motivation. Negative symptoms appear to contribute more to poor quality of life, functional ability, and the burden on others than do positive symptoms.^[22]People with greater negative symptoms often have a history of poor adjustment before the onset of illness, and response to medication is often limited.^[10][23]

Onset

See also: Pediatric schizophrenia

Late adolescence and early adulthood are peak periods for the onset of schizophrenia,^[4] critical years in a young adult's social and vocational development.^[24] In 40% of men and 23% of women diagnosed with schizophrenia, the condition manifested itself before the age of 19.^[25] To minimize the developmental disruption associated with schizophrenia, much work has recently been done to identify and treat the prodromal (pre-onset)phase of the illness, which has been detected up to 30 months before the onset of symptoms.^[24] Those who go on to develop schizophrenia may experience transient or self-limiting psychotic symptoms^[26] and the non-specific symptoms of social withdrawal, irritability, dysphoria,^[27] and clumsiness^[28] during the prodromal phase.culled from Wikipedia