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Schizophrenia: Symptoms


There is not one essential symptom that must be present for a ... activity, extreme negativism or mutism, peculiar voluntary movement, echolalia or echopraxia ... – PowerPoint PPT presentation

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Title: Schizophrenia: Symptoms

Schizophrenia Symptoms
  • 03/30/05

Schizophrenia is a PSYCHOTIC DISORDER (i.e., a
severe mental disorder in which thinking and
emotion are so impaired that the individual is
seriously out of contact with reality).
Schizophrenia actually refers to a group of
disorders. There is not one essential symptom
that must be present for a diagnosis. Instead,
patients experience different combinations of the
main symptoms of schizophrenia.
Two categories of symptoms in schizophrenia
  • Positive symptoms
  • Negative symptoms

Positive Symptoms
  • Distortions or excesses of normal functioning
    (e.g., delusions, hallucinations, disorganized
    speech/thought disturbances, motor disturbances)
  • Positive symptoms are generally more responsive
    to treatment than negative symptoms

  • False beliefs that are firmly and consistently
    held despite disconfirming evidence or logic
  • Individuals with mania or delusional depression
    may also experience delusions. However, the
    delusions of patients with schizophrenia are
    often more bizarre (highly implausible).

Types of delusions
  • Delusions of persecution belief that one is the
    target of others mistreatment, evil plots,
    and/or murderous intent (most common)
  • Delusions of reference belief that all
    happenings revolve around oneself, and/or one is
    always the center of attention

Types of delusions
  • Delusions of grandeur belief that one is a
    famous or powerful person from the past or
  • Delusions of control belief that some external
    force is trying to take control of ones thoughts
    (thought insertion), body, or behavior

Example of delusions of controlThought
insertion Believing that thoughts that are not
your own have been placed in your mind by an
external sourceA 29-year-old housewife said, I
look out of the window and I think the garden
looks nice and the grass looks cool, but the
thoughts of Eamonn Andrews come into my mind.
There are no other thoughts there, only his He
treats my mind like a screen and flashes his
thoughts on it like you flash a picture.
Types of delusions
  • Thought broadcasting belief that ones thoughts
    are being broadcast or transmitted to others
  • Thought withdrawal belief that ones thoughts
    are being removed from ones mind

Thought broadcasting Believing that your
thoughts are broadcast or transmitted, so that
others know what you are thinkingA 21-year-old
student found that As I think, my thoughts leave
my head on a type of mental ticker-tape. Everyone
around has only to pass the tape through their
mind and they know my thoughts.
  • Sensory experiences in the absence of any
    stimulation from the environment
  • Any sensory modality may be involved auditory
    (hearing) visual (seeing) olfactory (smelling)
    tactile (feeling) gustatory (tasting)
  • Auditory hallucinations are most common

Common auditory hallucinations in schizophrenia
  • Hearing own thoughts spoken by another voice
  • Hearing voices that are arguing
  • Hearing voices commenting on ones own behavior

Disorganized Speech / Thought Disturbances
  • Problems in organizing ideas and speaking so that
    a listener can understand
  • Loose Associations (cognitive slippage)
    continual shifting from topic to topic without
    any apparent or logical connection between
  • Neologisms new, seemingly meaningless words that
    are formed by combining words

Example of loose associationsMy thoughts get
all jumbled up. I start thinking or talking about
something but I never get there. Instead, I
wander off in the wrong direction and get caught
up with all sorts of different things thaty may
be connected with things I want to say but in a
way I cant explian. People lisetning to me get
more lost than I do My trouble is that Ive got
too many thoughts. You might think about
something, lets say that ashtray and just think,
oh yes, thats for putting my cigarette in, but I
would think of it and then I would think of a
dozen different things connected with it at the
same time.
Disorganized Motor Disturbances
  • Extreme activity levels (unusually high or low),
    peculiar body movements or postures (e.g.,
    catatonic schizophrenia), strange gestures and

Negative Symptoms
  • Behavioral deficits that endure beyond an acute
    episode of schizophrenia
  • More negative symptoms are associated with a
    poorer prognosis
  • Some negative symptoms might be secondary to
    medications and/or institutionalization

Types of negative symptoms
  • Anhedonia inability to feel pleasure lack of
    interest or enjoyment in activities or
  • Avolition inability or lack of energy to engage
    in routine (e.g., personal hygiene) and/or
    goal-directed (e.g., work, school) activities

Types of negative symptoms
  • Alogia lack of meaningful speech, which may take
    several forms, including poverty of speech
    (reduced amount of speech) or poverty of content
    of speech (little information is conveyed vague,
  • Asociality impairments in social relationships
    few friends, poor social skills, little interest
    in being with other people

Types of negative symptoms
  • Flat affect no stimulus can elicit an emotional
    response. Patient may stare vacantly, with
    lifeless eyes and expressionless face. Voice may
    be toneless. Flat affect refers only to outward
    expression, not necessarily internal experience.

Schizophrenia Subtypes
  • Paranoid Type preoccupation with one or more
    delusions or frequent auditory hallucinations
  • Disorganized Type disorganized speech,
    disorganized behavior, and flat or inappropriate
  • Catatonic Type motoric immobility or excessive
    motor activity, extreme negativism or mutism,
    peculiar voluntary movement, echolalia or
  • Undifferentiated Type none of the above
  • Residual Type Absence of prominent delusions,
    hallucinations, disorganized speech/behavior but
    odd beliefs/behavior or negative symptoms