Symptoms of Schizophrenia

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What are the initial symptoms of schizophrenia?

Schizophrenia often begins with psychosis, or a “break with reality.” (The word “psychosis” means a defective or lost contact with reality.) When a person is psychotic, they usually cannot tell whether their perceptions, thoughts and beliefs are real or not.

Initial symptoms usually appear in late adolescence or early adulthood. It is possible to develop schizophrenia as a young child or as an older adult, but that is unusual.

“Positive” and “Negative” symptoms of schizophrenia

Psychiatry uses the terms “positive” and “negative” to classify the symptoms of schizophrenia.

“Positive” symptoms refer to the experiences a person with schizophrenia has that are not common to others. Examples include delusions (unreal beliefs) and hallucinations (unreal perceptions). 

“Negative” symptoms represent the absence of capacity common to persons without schizophrenia. Examples include:
    -avolition (lack of ability to plan behavior)
    -flat affect (an impaired ability to express emotions and other non-verbal information)
    -cognitive impairments (difficulty with logic and comprehension)

What pattern, if any, do symptoms follow?

Over time, the “positive” symptoms of schizophrenia may come and go—sometimes spontaneously, sometimes as the result of treatment.

“Negative” symptoms are more likely to persist—and are often more disabling. They are also more often misunderstood. For example, avolition can be interpreted as “laziness” or “lack of willpower” and flat affect can be interpreted as “having no concern about others.”