Schizophrenia

Approximately 1% of the population has schizophrenia. The disorder typically occurs in late adolescence or young adulthood, although it can develop at any time in life. Women tend to develop schizophrenia at an older age than men. Despite popular belief, schizophrenia is not a “split personality.” At present, psychiatrists use three categories of symptoms to describe schizophrenia: positive symptoms, negative symptoms, and cognitive symptoms. Positive symptoms include psychotic symptoms. The term “positive” is used to describe a thought process that is usually not present; “negative” refers to a normal process that is absent; and “cognitive” refers to the way a person thinks.

Psychotic symptoms are sometimes frightening. Even people without a psychotic disorder may experience these types of symptoms in times of extreme stress, or with some medical illnesses. Psychotic symptoms seem completely real to the person who experiences them. The experience is something like a dream. Just as in a dream, the situation (for instance, that someone is plotting against you) seems very real. However, upon waking, it is clear for the normal person that the plot was “just a dream.” For the person with schizophrenia, the plot, or other delusion, continues to seem real. Negative symptoms and cognitive symptoms are more subtle, but often impair the individual’s ability to function on a day to day basis.

Positive symptoms include:

• Hallucinations, or hearing or seeing something that is not present. Hallucinations can occur with any of the senses, although hearing and seeing things that are not there (auditory or visual hallucinations) are more commonly reported. Individuals may also smell things (olfactory hallucinations) or feel things (tactile hallucinations) that are not there.
• Delusions, or false beliefs. The person may feel that someone is plotting against him, or that he is receiving special messages from the television or radio.
• Thought disorder. The person may have difficulty making sense when she talks because her thoughts are jumbled and disjointed.
• Movement Disorder. The person may be clumsy and uncoordinated, be prone to involuntary movements, grimace, or exhibit other unusual mannerisms.

Negative symptoms include:

• Amotivation, which means lacking the drive to do things (a symptom which is often very frustrating to family members)
• Low energy
• Inability to experience pleasure
• Lack of emotional response (immobile facial expression, monotonous voice)

Cognitive symptoms include:

• Problems with attention and concentration
• Problems with memory
• Problems with planning and organizing
• Difficulty making decisions

Different people with schizophrenia may have any of these symptoms to varying degrees. In addition, the symptoms can be very mild, or very severe.