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Symptoms of schizophrenia

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Symptoms 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 They may become socially isolated and withdrawn to such an extent that they refuse to get out of bed or eat a meal.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.

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

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