Symptoms of schizophrenia vary widely from one individual to another. Some schizophrenics suffer from auditory or visual hallucinations, while others may exhibit signs of paranoia or anxiety. At the root of all schizophrenia symptoms is psychosis: an impaired ability to distinguish between real and unreal perceptions.

Split Personality

The term schizophrenic comes from the term "split mind." This has lead to the popular belief that schizophrenics have a split personality or multiple personalities.

Split personality is not one of the symptoms of schizophrenia. Schizophrenia sufferers have only one personality. However, symptoms of schizophrenia may cause wide varieties in behavior that can make an individual seem to have a split personality.

Early Symptoms of Schizophrenia

Symptoms of schizophrenia may develop suddenly, or take years to develop. Often the initial symptoms include confused behavior and severe behavioral changes that add to the misconception that schizophrenia equals a split personality.

Positive and Negative Symptoms of Schizophrenia

Symptoms of schizophrenia are classified as "positive" and "negative" symptoms. Positive symptoms cause an excess of normal mental and cognitive functions: hallucinations, paranoia, and delusional thoughts are examples of positive symptoms.

Negative symptoms of schizophrenia refer to a deadening, or loss of normal mental function. Examples of negative symptoms include a lack of emotions and loss of motivation. Negative symptoms of schizophrenia are predominate in one-third of all schizophrenia symptoms. Schizophrenia patients exhibiting negative symptoms often do not respond as well to treatment as schizophrenics who exhibit mostly positive symptoms.

Positive Symptoms of Schizophrenia: Paranoia, Hallucinations and Delusional Thoughts

Positive symptoms of schizophrenia represent hypersensitivity and hyperawareness of thoughts and cognitive functions.

Delusional thoughts and paranoia: Delusional thoughts are personal beliefs that cannot be changed by reasoning or evidence to the contrary. Delusional thoughts often cause paranoia: schizophrenics may believe people are plotting against them, trying to poison them, or stalking them. Sometimes the delusional thoughts that trigger paranoia can be extremely bizarre, such as believing that the television is sending controlling signals directly to their brain.

Approximately one-third of delusional thoughts in schizophrenia sufferers cause paranoid symptoms. In addition to paranoia, schizophrenia may cause delusions of grandeur: the schizophrenic may believe he or she is a famous person or is extremely important.

Auditory and visual hallucinations: Hallucinations are sensory perceptions that have no basis in reality, and are common symptoms of schizophrenia. Hallucinations can affect any of the senses: schizophrenia sufferers experience auditory, visual, tactile, olfactory, and taste hallucinations.

Auditory hallucinations are the most common hallucinatory symptoms experienced by schizophrenics. Hearing voices is the most common of auditory hallucinations produced by schizophrenia. Voices may give schizophrenia sufferers instructions, carry on conversations, or plague schizophrenics with criticism.

Bizarre Behavior: Symptoms of schizophrenia may produce exceedingly bizarre behavior. Schizophrenics are often extremely agitated. Auditory hallucinations or paranoia may make some people act aggressively, although actual violence rarely occurs. In response to their symptoms, schizophrenics may talk to themselves, neglect personal hygiene, or act in socially inappropriate manners. Symptom severity varies: at times the schizophrenic may seem normal, then suddenly become erratic. These changes in symptoms add to the belief that schizophrenics suffer from split personality.

Negative Symptoms of Schizophrenia

Negative symptoms of schizophrenia are often less noticeable than positive symptoms, although they may be just as debilitating. Negative symptoms include asociality, impoverished speech, and flattened "affect," or blunted emotions.

Asociality and schizophrenia: Asociality shares many symptoms with depression. The schizophrenic becomes socially withdrawn, and experiences a severe loss of motivation. Asociality symptoms include indifference, lowered work or school performance, and impaired social functioning. A schizophrenia patient experiencing asociality symptoms may neglect personal hygiene, and become unresponsive to his or her surroundings.

Flattened affect symptoms and impoverished speech: Flattened affect refers to a deadening, or blunting, of emotions (affect = emotions). Symptoms include an overall lack of emotional expression. Flattened affect often leads to impoverished speech. The schizophrenic may talk in a monotone due to low emotional levels. Other symptoms of impoverished speech include vocabulary loss and limited word use.

Positive Symptoms, Negative Symptoms, and Reality Perception

Auditory/visual hallucinations, delusional thoughts, and paranoia make a schizophrenia patient's perception of reality very different from other people's notions of reality. Distorted perceptions of reality cause symptoms such as fear, anxiety, and confusion. Hallucinations and other symptoms may make schizophrenia patients seem detached and preoccupied: Severe cases of schizophrenia may leave people in catatonic states, sitting motionless for long periods of time. Other schizophrenics may be unable to sit still, moving or fidgeting constantly.

Violent Symptoms of Schizophrenia and Suicide

Violent behavior, despite its popular association with the disorder, is rarely one of the symptoms of schizophrenia. In general, schizophrenics are only marginally more prone to violence than other people.

Unfortunately, incidents involving violence and schizophrenia are often sensationalized in the media, continuing the myth that all schizophrenics are violent. Generally, schizophrenics who commit violent acts suffer from auditory hallucinations or delusions "ordering" the person to commit violence.

Most violent schizophrenics have a history of violent or criminal behavior prior to the onset of schizophrenia. Schizophrenics are much more likely to be a danger to themselves than others. Auditory/visual hallucinations, paranoia, and other symptoms of schizophrenia lead to suicide attempts in up to one-third of schizophrenics. Early diagnosis and treatment of symptoms lowers the risk of suicide.

Resources

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Fauci, A., Braunwald, E., Isselbacher, K., Wilson, J., Martin, J., Kasper, D., Hauser, S. & Longo, D. (ed). Harrison's Principles of Internal Medicine, 14th Edition . McGraw-Hill, New York, 1998.

Murphy, M., Cowan, R. & Sederer, L. Blueprints in Psychiatry. Blackwell Publishing, Massachusetts, 2004.

Spearing, M.K. (2002, August). Schizophrenia [NIH Publication No. 02-3517]. National Institute of Mental Health.

National Library of Medicine. (updated 2004). Schizophrenia. MedlinePlus Medical Encyclopedia.

National Mental Health Information Center. (2003, April). Schizophrenia. NMHIC brochure [KEN98-0052].