Symptoms and Features of Schizophrenia

Symptoms: experienced by the individual and used to diagnose the mental health disorder
1. Positive: add to normal behaviour, or change normal behaviour, can be affected by cultural differences, hold a greater weight in diagnosis
  1. Thought insertion: A person thinks their own thoughts have been implanted by someone else, an external force over which they have no control.
  2. Hallucinations: Experiencing something that is not really there through one of the five senses, e.g. hearing voices or seeing things that aren’t there. For auditory hallucinations (most common in schizophrenia), the voice is often harsh and critical – they may provide a commentary of what the person is doing or control the person by giving orders.
  3. Delusions: A delusion is a firm belief or idea that conflicts with reality; a false belief. E.g. thinking their behaviour is being controlled by someone else.
    1. Grandiose delusions: holding false beliefs about being in a position of power, e.g. false beliefs about being a king or possessing a special power such as the cure for cancer.
    2. Persecutory delusions: holding false beliefs that others are trying to harm them in some way, e.g. falsely believing someone is spying on them or plotting against them. Referential delusions: holding false beliefs that unrelated information is directly related to them. E.g. the false belief that newspaper headlines hold secret messages for them.
  4. Disordered thinking: Muddled thinking that may make speech disorganised and hard to follow. They will find it difficult to organise their thoughts logically and may speak in a “word salad” of unconnected words and phrases. They may stop mid-sentence, as if the thought has left their head, jump from topic to topic, and may make up words that have no meaning, called neologisms.
2. Negative: remove something from normal functioning, easier to operationalise and measure objectively, may start before positive symptoms (years before diagnosis)
  1. Flatness of emotion: Reduction in emotional expression, e.g. lack of facial expressions, lack of eye contact and a dull monotone voice.
  2. Social withdrawal: Avoidance of interaction with friends and family and/or not going out
  3. Lack of energy and apathy: “avolition” No motivation for carrying out normal daily tasks, such as work.
  4. Lack of pleasure: Not experiencing pleasure from previously enjoyable activities such as hobbies, social interaction, sex and exercise.
Features: facts that describe the mental disorder such as statistics
1. The average life expectancy for individuals with schizophrenia is ten or more years less than average, due to health problems associated with the disorder or higher suicide rate.
2. The NHS suggests that 1% of people will experience at least one episodic of acute schizophrenia in their lifetime.
3. Goldstein (1988): Male sufferers experience a more severe course of schizophrenia than females (more visits to and more time in hospital)
4. To be used as ONE feature. Each fact individually is not ONE feature.
  1. ¼ of patients will have one episode of schizophrenia then fully recover.
  2. ¼ of patients will suffer chronic (long-term) schizophrenia.
  3. ½ of patients will have occasional schizophrenic episodes.
5. Schizophrenia tends to be diagnosed during adolescence up to about age 30.
6. It is a universal disorder, affecting both males and females, but it has an earlier average onset amongst males (early to mid twenties in males, compared to late twenties in females).
7. Positive symptoms are more treatable than negative symptoms

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Symptoms and Features of Schizophrenia

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