What Are the Symptoms of Schizophrenia?

Positive Symptoms: Positive symptoms mark the presence of distinctive behaviors. There are many different positive symptoms of schizophrenia. Schizophrenic patients may experience strange or paranoid delusions. They may believe that they are being persecuted by others or having their minds controlled by others. Positive symptoms may include disturbing or frightening hallucinations. The most common hallucinations are auditory (heard), but visual hallucinations may also occur. Other positive symptoms include sensitivity to and fear regarding ordinary sights, sounds, or smells; agitation; tension; and insomnia.

Negative symptoms: Negative symptoms mark the absence of normal social and interpersonal behaviors. There are various negative symptoms of schizophrenia. Schizophrenic patients are often less able to experience appropriate emotions or express their emotions. This reduced expression is known as a blunted affect. Because they respond less and have less

desire to interact with others, these patients often withdraw from others. Other negative symptoms may also include a lack of motivation, energy, and ability to experience pleasure. Schizophrenic patients speak less and avoid speaking to others.

Cognitive symptoms: Schizophrenic patients may have confused thinking and speech, which makes it difficult for them to communicate effectively with others. Fractured (broken or fragmented) thoughts and communication are considered types of disorganized cognitive symptoms. Individuals with schizophrenia often seem to lose their train of thought and combine unrelated topics in a way that prevents a coherent conversation. Disorganized behaviors such as unnecessary, repetitive movements are also common. Schizophrenics often seem restless or hyperactive. They may have difficulty paying attention or maintaining an organized lifestyle.

How Is Schizophrenia Diagnosed?

Schizophrenics often first give what are known as prodromal signs, or signs preceding a psychotic episode. Schizophrenic prodromal signs may include social isolation, odd behavior, lack of personal hygiene, and blunted emotions. The prodromal phase is followed by one or more separate psychotic episodes. Physicians examining their behavior patterns first attempt to rule out disorders of mood that respond to antidepressants, such as bipolar disorder. Sometimes schizophrenia is diagnosed through the patient's response to different therapeutic regimens. Schizophrenic symptoms are not affected by antidepressant medications*, but they are relieved by antipsychotics.

Once other disorders have been excluded the criteria for a diagnosis of schizophrenia is that a patient be continuously ill for at least six months and that there be one psychotic phase followed by one phase of odd behavior. During the psychotic phase, one or more of three groups of psychotic symptoms must be present. The three groups are delusions, hallucinations, and a disordered or incoherent thought pattern.

How Is Schizophrenia Treated?

Schizophrenic patients are diagnosed and treated by psychiatrists. A licensed therapist may perform rehabilitation therapy to help a schizophrenic patient function during times when they are not in a psychotic episode. Treatment teams from supportive agencies may help with everyday living. Schizophrenia is treated with antipsychotic drugs used in the lowest effective doses. The antipsychotic drugs work mainly to antagonize (inhibit) dopamine and serotonin receptors in specific areas of the brain that are in dysfunction. Earlier antipsychotic medicines functioned primarily on dopamine receptors and had more side effects than later medications that also work on serotonin receptors. The older medications sometimes

caused serious side effects such as severe, involuntary, repetitive movements of the face, arms, and legs (called tardive dyskinesia). The later medications do not have such troubling side effects. Positive symptoms of schizophrenia respond better to antipsychotic medications than the negative symptoms.

Although antipsychotic drug treatment is necessary for schizophrenic patients, it is notenough. Patients also require supportive psychotherapy. Various psychosocial treatments are available for varying stages in the disease, and each patient requires a unique treatment regimen. Doctor and therapist appointments for  medication management and psychological

support are necessary in all stages of recovery, even when symptoms are under control. Peer support groups are also important. Assertive community treatment (ACT) programs are available for more severely affected patients. 'These programs may provide intensive services within a patient's home on a day-to-day basis. ACT teams can follow patients through all courses of their illness and assist them in normal living activities. Patients who are in the later stages of recovery and have few lingering symptoms may get involved with programs designed to help them achieve personal goals pertaining to work, education, and social interactions.

What Is the Prognosis for Schizophrenia?

The prognosis for schizophrenia varies according to each case. A diagnosis of schizophrenia does not necessarily mean that a person will experience a life-long illness. Over a period of 25 to 30 years approximately one-third of schizophrenic patients experience remission or even partial recovery. Some individuals lose their severe symptoms or learn to live acceptably

with some minor symptoms. However, schizophrenia can be a severe and even dangerous disorder. A wide range of outcomes has been reported, including episodes of violence or severe incapacity. Quite a few schizophrenic patients are at risk for suicide. Suicide, accidents, and disease are common among patients with schizophrenia, along with an approximate

10-year decrease in life span. Typically, individuals have episodes of psychosis and episodes of remission, with the outcome dependent on how effectively the medicine keep the patient in periods of remission and how well the patient is able to deal with the symptoms still associated with these periods.

What Special Concerns Exist for Schizophrenia?

One concern for these patients is that they may not go  along with the treatment medical professionals say they need. Some patients may not remain in close contact with their treatment team, they may not take all their medications consistently, and they may not keep all their appointments. Schizophrenic patients are notorious for not being compliant with their necessary medications, either because they feel they have improved and no longer need medication or because they want to avoid the side effects it causes. Unfortunately, without proper and consistent drug intervention psychotic episodes are highly likely to recur.

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