Updated 17 March 2016

Symptoms of schizophrenia

The symptoms of schizophrenia can be classified into three categories – positive, negative and cognitive.

Symptoms of schizophrenia are divided into positive, negative and cognitive categories as follows:

  • Positive symptoms are characterised by delusions, hallucinations, disorganised speech and/or behaviour.
  • Negative symptoms consist of social withdrawal, lack of motivation, emotional blunting and lack of energy.
  • Cognitive symptoms include difficulty with attention, concentration and memory.

Positive symptoms

Hallucinations are abnormalities in perception (when someone experiences sensations without an outside stimulus). For example, a person may hear voices speaking outside his or her head although there is no one present, or see things that do not exist (auditory).

Delusions are fixed false beliefs that a person firmly holds. Despite logical arguments or proof to the contrary, they cannot be convinced differently. These beliefs are not in keeping with the person’s own cultural beliefs or background.

While such thoughts may be based on reality, they have an incorrect interpretation of the situation. A person may believe that people are watching him, that everybody is against him or that the television is broadcasting his thoughts to everyone in his neighbourhood.

Negative symptoms

People suffering from schizophrenia often lack social interaction with other people. They may become socially isolated and withdrawn to such an extent that they refuse to get out of bed or eat a meal. They may take poor care of themselves and therefore often neglect their personal appearance. Others may often wrongly interpret these symptoms as laziness.

Cognitive symptoms

People with schizophrenia have difficulty in focusing their attention and concentrating for a long time. They also have difficulty with memory. These symptoms are often most debilitating for people suffering from schizophrenia.

Phases of schizophrenia

  • Pre-morbid phase: period prior to onset of symptoms.
  • Pro-dromal or pre-psychotic phase: early symptoms involving changes in thoughts, feelings and behaviour may occur prior to the onset of the frank psychotic symptoms.
  • Acute phase: psychotic symptoms such as hallucinations, delusions, disorganised behaviour and disorganised thinking are experienced.
  • Residual or recovery phase: acute symptoms have subsided; some odd beliefs, vague abnormal perceptions and negative symptoms may persist.

It is often difficult to differentiate these four phases and symptoms of psychosis may occur to varying degrees in all four phases.

When to call a health professional

Call your doctor or mental health professional without delay if you or a friend or family member exhibits behaviour that suggests loss of contact with reality, or if any other symptoms suggestive of psychosis, develop.

Read more: 

What is schizophrenia?

The causes of schizophrenia

Treating schizophrenia

Reviewed by DrTasneem Mahomed, MBBCh(Wits), FC Psych (SA),MmedPsych (Wits),Psychiatrist in private practice, Cape Town. (March 2015)


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