The symptoms of schizophrenia are more well known than the cause. Diagnosis is based on a characteristic set of symptoms that must last for at least several months. According to the National Institute of Mental Health, the "psychotic symptoms" include:
These symptoms are referred to as positive symptoms because they are highly visible and not present in people without the disease. Negative symptoms, which are less readily observed and involve a decrease in normal functions and include:
A person with negative symptoms might be found simply sitting and staring blankly at the world, no matter what is happening. Various cognitive, or disorganized, symptoms may or may not be present, including difficulty paying attention, poor working memory, and limited ability to process information and make informed decisions (executive functioning).
In addition to the symptoms listed above, other issues often present in schizophrenia include disconnected speech patterns, broken sentences, excessive body movement, and purposeless activity. Those living with the disease may also experience states of extreme anger and hostility.
Schizophrenia is thought to possibly operate by disrupting the way in which brain cells communicate with each other. The neurotransmitters that carry signals from one brain cell to another might be abnormal in those with the disease. Malfunction in one of the transmitters, dopamine, seems to be a source of the problem, though the issue is not fully understood. The connection is suspected because the major medicines that are successful in the treatment of schizophrenia limit the production or carrying power of dopamine. The neurotransmitter glutamate may also be involved. Another likely suspect is serotonin, a transmitter whose presence or absence has important influences on behavior.
Schizoaffective disorder is a condition in which patients exhibit symptoms of both schizophrenia and a mood disorder. Schizophrenia is characterized by:
A mood disorder is characterized by episodes of depression and/or mania.
Some patients with schizoaffective disorder can feel isolated and have trouble maintaining relationships with family and friends and holding a steady job. Other patients with schizoaffective disorder can be inappropriately dependent on family and friends. Patients can experience depressed appetite and rapid weight loss and/or self-destructive eating binges and rapid weight gain. They can experience bursts of energy and/or periods of listlessness. They can sleep for long periods of time and/or experience insomnia. They can experience increased feverish, interest in work and/or complete loss of interest in such activity. Many patients experience feelings of worthlessness and unfounded guilt that can spiral into suicide ideations or a willingness to indulge reckless behavior, including promiscuity and drug and/or alcohol abuse.
Treatment is wide-ranging and often involves medications at minimum dosages to prevent extreme side effects, which can include muscle twitching and the inability to sleep. Mood stabilizers may be given to patients who have the bipolar subtype of schizoaffective disorder, while antidepressants may be given to patients with the depressive subtype. Antipsychotics may be given for persistent psychosis. But long-term process treatment includes broad nonjudgmental, nonantagonistic family support; supervised support groups and private counseling; and commitment to both work and to community activities.
Delusions are false beliefs that are associated with misinterpretations of perceptions or experiences. There are different types of delusions. The most common are persecutory delusions and grandiose delusions.
Hallucinations are false perceptions in the absence of any real stimulus. Hallucinations may involve any of the five senses. There are:
