Schizophrenia. This concept from the field of medicine can be heard quite often in everyday life. What do people mean when they call a person schizophrenic?

Most often you can hear the answer that a schizophrenic is a person with abnormal behavior, from the point of view of others. But this does not mean that he is suffering from schizophrenia.

An abnormal, non-standard style of behavior that is not characteristic of a particular person is not an indicator of schizophrenia. The reason for this behavior may be deep personal experiences, severe stress, chronic fatigue, and the consequences of experienced trauma.

Therefore, a clear understanding of the symptoms of schizophrenia can help distinguish this disease from other diseases.

What is schizophrenia

The main difference between schizophrenia and other mental illnesses is that the cause of its occurrence is associated with internal changes occurring in the body. That is, external factors in no way can become a prerequisite for the development of this disease, which cannot be said about other mental disorders. In particular, signs such as delirium and sudden changes in mood can be the result of a traumatic brain injury, manifestations of hysteria - a consequence of severe emotional shock, etc.

Psychiatrists consider schizophrenia to be a chronic disease in which a person’s perception of the outside world is disrupted, as well as a disorder of thinking with completely satisfactory intellectual functioning.

Moreover, the degree of mental development in a patient with schizophrenia can be either low or quite high - at the level of genius.

The uniqueness of this disease lies in the fact that the organs of perception, intellect, and memory function correctly. The problem arises when the brain, having perceived information from the outside, transmits it to the consciousness for processing. It is at this stage that distortion of the information received occurs. That is, there is a breakdown in consciousness, which is unable to create a correct objective picture of the external world. This is evidenced by the very name of the disease: schizophrenia - “disorder of consciousness.”

Primary signs

A characteristic sign of schizophrenia, in most cases, is the gradual increasing progress of the disease with the manifestation of two or three symptoms at an early stage, which over time can worsen and be added by other signs.

The initial stage of schizophrenia can be recognized by the presence of the following symptoms:

• Loss of the ability to perform even basic household tasks due to a lack of understanding of the need to perform them (for example, the patient does not wash his clothes, since they will still be dirty again);
• Speech disorders (slow speech, predominantly monosyllabic answers to questions);
• Emotional rigidity (slowness of emotional reactions);
• Inability to concentrate on an object;
• Loss of interest in previously meaningful activities.

Insufficient attention to these manifestations often leads to the development of more serious symptoms of schizophrenia. In psychological science they are usually divided into 4 groups:

1. Positive;
2. Negative;
3. Disorganized;
4. Affective.

Positive symptoms

Scientists call positive symptoms that appear during the development of the disease.

By “positive” symptoms we do not mean the formation of good qualities, but the appearance of new signs that are uncharacteristic of a healthy personality.

Psychiatrists consider positive symptoms:

Hallucinations.

These are disturbances in the perception of information from the outside world. A person receives it thanks to the presence of his sense organs. Hallucinations manifest themselves at the level of sensations that do not actually exist. A person hears non-existent sounds, voices or speech that come from the outside world or “sit” in his head.
The peculiarity of the hallucinations of a patient with schizophrenia is that he actually feels them, and does not just imagine them. A schizophrenic really sees and hears aliens, smells vanilla from cutlets, etc.

Rave.

This is the presence of a set of certain beliefs that do not coincide with reality. Delusions can form autonomously during the development of schizophrenia, as well as as a result of the effects of hallucinations.
There are many types of delusions, depending on the nature of the beliefs that arise. Very often, the development of delusions of persecution is observed, when the patient thinks that someone is watching him, pursuing him, “breathing in his back.” Delusions of influence are also widespread, when a person believes that someone controls him and constantly influences his life.

Inappropriate behavior.

Illusions.

Inappropriate behavior can manifest itself in excessive excitement, a high degree of naivety and stupidity, as well as through a discrepancy between the style of behavior and appearance and the circumstances. The most severe stage of this behavior is catatonia - a person adopts absurd poses for a long time or chaotic, confused movements.

Negative symptoms

Negative symptoms are human qualities that have disappeared or become severely dulled by a progressive disease.

Characteristic signs of negative symptoms are:

• Decreased energy;
• Manifestation of pessimism and indifference;
• Craving for loneliness;
• Decreased physical activity;
• Disorders of speech abilities and thinking;
• Inability to concentrate on a subject or moving object;
• Wave-like mood;
• Lack of self-control;
• Lethargy;
• Reduced emotional reactions;
• Mother of motivation, etc.

Often in a work group or entrance hall you can meet a quirky or sloppily dressed person with an unconventional attitude towards others and inappropriate behavior. And the reason for these oddities may be a sign of schizophrenia - a mental disorder that changes the essence of a person.

The term “schizophrenia” was formed from two Greek words: “schizo” - splitting, “phren” - mind. The name of the disease was coined by psychiatry professor Paul Eugen Bleuler and stated that it should remain relevant until scientists find an effective cure. The symptoms of the disease itself were described by a psychiatrist from Russia back in 1987, although at that time it had a different name - “ideophrenia.”

How to recognize a schizophrenic?

First of all, this concerns speech. It should be noted that in oral speech there are many introductory words, the sentences are complex and ornate, but there is little meaning. But with schizophasia, speech is broken and confused. Word creation is also possible, that is, inventing your own words.

There are special stresses and intonation that are not characteristic of ordinary “healthy” speech.

In the written speech of a schizophrenic, nonsense and a bunch of words are also visible. It is very difficult to describe and narrate. They are so compressed that it is difficult to understand what they are talking about. Punctuation and case marks may be missing.

Another indicator of how to recognize a schizophrenic is behavior. It is a continuation of the way of thinking. Often it is mannered, the conversation is conducted in an imperative mood.

This can be a proud, majestic pose. Clothes can be pretentious, even specially designed. During attacks, behavior is especially emotional and bright. Movements, like speech, are characterized by meaninglessness, incoherence and fragmentation. Among the most striking and constant phenomena in a schizophrenic are trunk-shaped stretching of the lips, grimaces and impulsive actions.

Already at the first stages of the disease, there is a lack of liveliness and brightness of emotions. But a special feature that will answer the question of how to recognize a schizophrenic is sharp and frequent fluctuations from sensitivity to complete indifference.

There is a weakening of sexual desire, the special strength of which is manifested in thoughts and fantasies, which are most often of a perverted nature.

As the disease progresses, the sense of tact becomes dull, the appearance becomes extremely untidy, and the home is a complete mess.

Physiologically, delayed puberty is observed. The eyeballs may be sunken, the palpebral fissures may be small. The skin is often greasy, increased sweating. Reduced work capacity and tachycardia are common phenomena in schizophrenics.

People who have such a relative are often at a loss and do not understand how to exist with him under the same roof.

To avoid excesses, it is worth studying information on how to live with a schizophrenic:

Patients require long-term treatment and must be constantly monitored. During therapy there will certainly be exacerbations and relapses. It is necessary to create a volume of work and household chores for the patient and never exceed it.

Excessive care can cause harm. You shouldn’t get angry, scream, or get irritated with mentally ill people. They are unable to bear criticism.

You also need to know the signs of an impending suicide attempt:

General statements about the meaninglessness and frailty of existence, the sinfulness of people. Hopeless pessimism. Voices commanding suicide. The patient's belief that he is suffering from an incurable disease. Sudden calm and fatalism.

To prevent tragedy, you should learn to distinguish the “normal” behavior of a schizophrenic from the abnormal. One cannot ignore his conversations about the desire to commit suicide; an ordinary person is capable of seeking attention to his own person in this way, but with a schizophrenic everything is different.

You should try to convey to his mind that the illness will soon go away and relief will come. But this needs to be done gently and unobtrusively.

Video that will help you understand this issue in more detail

Advice from a practicing psychiatrist:

Life advice:

Schizophrenia is such a multifaceted disease in its manifestations that recognizing it in time can sometimes be quite difficult. Before the first obvious signs appear, the disease can slowly develop for years, and some oddities that appear in a person’s behavior are mistaken by many for a spoiled character or teenage changes. At the same time, having noticed such oddities, people often, instead of turning to a psychologist or psychiatrist, run to grandmothers or traditional healers to remove damage, roll out eggs, buy “magic” herbs, etc. Such actions only lead to a worsening of the patient’s condition and a delay in professional therapy. But it is precisely the early diagnosis of schizophrenia and timely treatment that can greatly improve the prognosis of the disease and provide a high chance of full recovery. What signs allow us to suspect the approach of the disease and identify a tendency to schizophrenia?

Signs of schizophrenic disorder in the pre-morbid stage

Schizophrenia is an endogenous disease and is associated with biochemical disorders of the brain. And pathological processes in the brain cannot but affect a person’s behavior and thinking. During childhood or adolescence, a person who may later develop schizophrenia does not stand out much from other people. However, some signs are still worth paying attention to. Such children are usually a little withdrawn and may experience learning difficulties. You can notice some oddities in their behavior, for example, washing hands too often, unusual hobbies, coldness towards animals. Of course, the fact that a child is lagging behind in school and behaves withdrawn does not mean that he will necessarily suffer from schizophrenia in the future. It’s just that such a child or teenager should be monitored more carefully. It would also be a good idea to consult with a child psychologist.

Incubation period of the disease

As the pathological processes of the brain in schizophrenia worsen, changes in the psyche and thinking become more pronounced. The incubation (prodromal) stage of the disease lasts on average about three years. Relatives do not always pay attention to gradually increasing oddities in the patient’s behavior, especially if this coincides with adolescence. Signs of the disease at this stage, which make it possible to understand whether a person has schizophrenia, may be as follows:

• strange behavioral reactions;
• desire for solitude, decreased initiative and energy level;
• changes in handwriting (for example, handwriting may become illegible or the slant of letters in handwriting may change);
• change in personality traits (a diligent and punctual teenager suddenly becomes absent-minded and careless);
• deterioration of creative, educational or working abilities;
• episodic simple hallucinatory or illusory manifestations;
• new extremely valuable hobbies, for example, philosophy, mysticism, religious ideas.

Graphologists believe that it is possible to understand whether there is a predisposition to schizophrenia by looking at a person’s handwriting.

Handwriting can say a lot about personality and thinking. However, illegible and intermittent handwriting in itself does not indicate schizophrenia; there must be other characteristic manifestations of the disease. If you begin to notice changes in handwriting or other signs in yourself or a loved one, you should consult a psychiatrist as soon as possible.

Self-diagnosis

Diagnosing schizophrenia is a difficult task even for experienced specialists. What can we say about trying to find out about the presence of such a complex disease on your own. An accurate diagnosis, determining the form of the disorder, can only be made after a series of examinations, differential diagnosis and conversation with a doctor. However, often people, due to a negative attitude towards psychiatry and stereotypical beliefs, are afraid to contact a psychiatrist, even if they discover alarming signs in themselves. Therefore, many are interested in how to identify schizophrenia in yourself without the help of a psychiatrist? You can figure out if you have cause for concern about schizophrenia with some self-testing techniques.

To get started, try the following statements for yourself:

• It’s difficult for me to remember recent events, but I remember clearly what happened a long time ago;
• I get bored from most conversations and I’m not interested in making new acquaintances;
• I sometimes find it difficult to carry out daily duties;
• sometimes I have thoughts that I am acting against my will;
• It can be difficult for me to forget even minor grievances;
• I often can’t bring myself to leave the house for days;
• I am sometimes attacked by stupor or sudden excitement with aggression;
• My thoughts are sometimes foggy and confused;
• I am confident that I have unique abilities;
• those around me are trying to control my feelings and thoughts;
• I’m not interested in anything, and I don’t want to do anything;
• I feel that my family is under threat;
• For me, the main adviser is my inner voice, I always consult with it;
• I am annoyed by close people for unknown reasons;
• I sometimes notice in myself a discrepancy between my expressed emotions and the surrounding environment and the emotions of other people;
• I often discover in myself an unreasonable feeling of fear;
• It’s difficult for me to show feelings of tenderness and love; I’m often self-absorbed.

Think about how true it would be for you to hear the following statements addressed to you from loved ones:

• you are not at all concerned about the suffering of other people or animals, your face does not reflect a feeling of compassion;
• you don’t look your interlocutor in the eyes;
• you sometimes talk out loud to yourself;
• you most like to spend time alone with yourself, avoid crowded places and attention from others;
• you hear something that is not really there, and what those around you do not hear;
• you began to speak indistinctly (stutter, lisp);
• your writing has become worse, your handwriting is somehow strange and illegible;
• you are considered a little eccentric, and strange expressions are noticed on your face;
• you talk to inanimate objects as if they were alive;
• you sometimes laugh or cry for no reason;
• you spend quite a lot of time on meaningless activities (you lie for hours, staring at the ceiling).

How to evaluate such testing? The more of the above statements apply to you, the higher your tendency and predisposition to schizophrenia and the more important it is for you to visit a specialist. Note that it is inclination! Because, even if absolutely all statements are identical to you, this does not mean that you have a schizophrenic disorder. Only a psychiatrist can make a diagnosis.

You can also understand whether you have signs of schizophrenia using the visual test “Chaplin's Mask”, created by British neuropsychologist R. Gregory. Experience in observing patients shows that a characteristic feature of schizophrenia is a person’s immunity to visual illusions.

While taking this test, don't take your eyes off the picture. If everything is in order with your psyche, you will notice the optical illusion.

Diagnostics and MSE

The process of diagnosis and MSE (medical and social examination) for schizophrenia can take quite a long time, since the manifestations of the disease are very diverse. Differential diagnosis allows you to exclude mental, somatic and neurological pathologies that have symptoms similar to schizophrenia. However, it is not always possible to make an accurate diagnosis immediately even after differential diagnosis. How does the diagnostic process work? To begin with, the psychiatrist assesses the patient’s condition during a conversation. It identifies productive and negative symptoms, as well as the degree of cognitive impairment. Various tests are often used. For example, one can fairly accurately predict schizophrenia based on eye movements.

A person with this pathology cannot smoothly follow a slowly moving object with his eyes. Specific eye movements in schizophrenics are also observed when freely viewing pictures. An experienced doctor is able to recognize signs of pathology in eye movements. It is also difficult for such people to keep their eyes still for a long time and fix their gaze on something. After the conversation, a series of examinations are carried out that allow us to assess the characteristics of the central nervous system, identify concomitant diseases, and endocrine disruptions. Studies such as EEG, MRI, TDS (special ultrasound scanning of cerebral vessels) allow more accurate differential diagnosis, assessment of the severity of schizophrenia and the most effective selection of medications. MRI for schizophrenia is one of the effective ways to solve the problem - how to recognize schizophrenia even before its obvious signs appear and the person’s well-being deteriorates. It has been proven that changes in brain structures begin long before the symptoms of schizophrenia develop.

During the treatment process, at each stage of remission, an MSE of the patient is performed. If the exacerbation is protracted, MSE can be performed during the attack. MSE evaluates the duration and clinical form of schizophrenia, the dynamics and nature of negative disorders, the type and characteristics of mental disorders. Also during the MSE process, it is important to assess how critical the patient is of his condition. During MSE, the stage of the disease, the nature of the leading syndrome and the quality of remissions are assessed. All this is necessary to determine the patient’s disability group based on the results of the MSA. The first group of disability is most often caused by a continuously ongoing malignant form of the disease, which develops early and causes a rapid increase in negative disorders.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

General characteristics of schizophrenia

At its core, it is a chronic disease in which a disorder of thinking and perception of any phenomena in the surrounding world develops against the background of a preserved level of intelligence. That is, a person with schizophrenia is not necessarily mentally retarded; his intelligence, like that of all other people, can be low, average, high, and even very high. Moreover, in history there are many examples of brilliant people who suffered from schizophrenia, for example, Bobby Fischer - world chess champion, mathematician John Nash, who received the Nobel Prize, etc. The story of John Nash's life and illness was brilliantly told in the film A Beautiful Mind.

That is, schizophrenia is not dementia or a simple abnormality, but a specific, completely special disorder of thinking and perception. The term “schizophrenia” itself consists of two words: schizo - to split and phrenia - mind, reason. The final translation of the term into Russian may sound like “split consciousness” or “split consciousness.” That is, schizophrenia is when a person has normal memory and intelligence, all his senses (vision, hearing, smell, taste and touch) work correctly, even the brain perceives all information about the environment as needed, but consciousness (cortex brain) processes all this data incorrectly.

For example, human eyes see green leaves of trees. This picture is transmitted to the brain, assimilated by it and transmitted to the cortex, where the process of understanding the information received occurs. As a result, a normal person, having received information about green leaves on a tree, will comprehend it and conclude that the tree is alive, it’s summer outside, there’s shadow under the crown, etc. And with schizophrenia, a person is not able to comprehend information about green leaves on a tree, in accordance with the normal laws characteristic of our world. This means that when he sees green leaves, he will think that someone is painting them, or that this is some kind of signal for aliens, or that he needs to pick them all, etc. Thus, it is obvious that in schizophrenia there is a disorder of consciousness, which is not able to form an objective picture from the available information based on the laws of our world. As a result, a person has a distorted picture of the world, created precisely by his consciousness from the initially correct signals received by the brain from the senses.

It is precisely because of such a specific disorder of consciousness, when a person has knowledge, ideas, and correct information from the senses, but the final conclusion is made with a chaotic use of its functionalities, the disease was called schizophrenia, that is, splitting of consciousness.

Schizophrenia - symptoms and signs

First, you should know that schizophrenia has symptoms and signs. Symptoms mean strictly defined manifestations characteristic of the disease, such as delusions, hallucinations, etc. And signs of schizophrenia are considered to be four areas of human brain activity in which there are disturbances.

Signs of schizophrenia

Associative defect – is expressed in the absence of logical thinking in the direction of any final goal of reasoning or dialogue, as well as in the resulting poverty of speech, in which there are no additional, spontaneous components. Currently, this effect is briefly called alogia. Let's look at this effect with an example in order to clearly understand what psychiatrists mean by this term.

So, imagine that a woman is riding on a trolleybus and a friend of hers gets on at one of the stops. A conversation ensues. One of the women asks the other: “Where are you going?” The second one answers: “I want to visit my sister, she’s a little sick, I’m going to visit her.” This is an example of a response from a normal person who does not have schizophrenia. In this case, in the second woman’s response, the phrases “I want to visit my sister” and “she’s a little sick” are examples of additional spontaneous components of speech that were said in accordance with the logic of the discussion. That is, the only answer to the question of where she is going is the “to her sister” part. But the woman, logically thinking through other questions of the discussion, immediately answers why she is going to see her sister (“I want to visit because she is sick”).

If the second woman to whom the question was addressed were schizophrenic, then the dialogue would be as follows:
-Where are you going?
- To my sister.
- For what?
- I want to visit.
- Did something happen to her or just like that?
- It happened.
- What's happened? Something serious?
- I got sick.

Such dialogue with monosyllabic and undeveloped answers is typical for the participants in the discussion, one of whom has schizophrenia. That is, with schizophrenia, a person does not think out the following possible questions in accordance with the logic of the discussion and does not answer them immediately in one sentence, as if ahead of them, but gives monosyllabic answers that require further numerous clarifications.

Autism– is expressed in distraction from the real world around us and immersion in our inner world. A person’s interests are sharply limited, he performs the same actions and does not respond to various stimuli from the surrounding world. In addition, the person does not interact with others and is not able to build normal communication.

Ambivalence – is expressed in the presence of completely opposite opinions, experiences and feelings regarding the same subject or object. For example, with schizophrenia, a person can simultaneously love and hate ice cream, running, etc.

Depending on the nature of ambivalence, three types are distinguished: emotional, volitional and intellectual. Thus, emotional ambivalence is expressed in the simultaneous presence of opposite feelings towards people, events or objects (for example, parents can love and hate children, etc.). Volitional ambivalence is expressed in the presence of endless hesitation when it is necessary to make a choice. Intellectual ambivalence is the presence of diametrically opposed and mutually exclusive ideas.

Affective inadequacy – is expressed in a completely inadequate reaction to various events and actions. For example, when a person sees someone drowning, he laughs, and when he receives some good news, he cries, etc. In general, affect is the external expression of the internal experience of mood. Accordingly, affective disorders are external manifestations that do not correspond to internal sensory experiences (fear, joy, sadness, pain, happiness, etc.), such as: laughter in response to the experience of fear, fun in grief, etc.

These pathological effects are signs of schizophrenia and cause changes in the personality of a person who becomes unsociable, withdrawn, loses interest in objects or events that previously worried him, commits ridiculous acts, etc. In addition, a person may develop new hobbies that were previously completely atypical for him. As a rule, such new hobbies in schizophrenia become philosophical or orthodox religious teachings, fanaticism in following any idea (for example, vegetarianism, etc.). As a result of personality restructuring, a person’s performance and degree of socialization are significantly reduced.

In addition to these signs, there are also symptoms of schizophrenia, which include single manifestations of the disease. The entire set of symptoms of schizophrenia is divided into the following large groups:

• Positive (productive) symptoms;
• Negative (deficient) symptoms;
• Disorganized (cognitive) symptoms;
• Affective (mood) symptoms.

Positive symptoms of schizophrenia

Positive symptoms of schizophrenia include the following:

• Rave;
• Hallucinations;
• Illusions;
• State of excitement;
• Inappropriate behavior.

Hallucinations are a violation of the perception of surrounding reality using the senses. That is, hallucinations mean certain sensations that do not exist in reality. Depending on which sense organ the hallucinations concern, they are divided into auditory, visual, olfactory, tactile and gustatory. In addition, hallucinations can be simple (individual sounds, noise, phrases, flashes, etc.) or complex (coherent speech, certain scenes, etc.).

The most common are auditory hallucinations, when a person hears voices in his head or in the world around him, sometimes it seems to him that thoughts were not produced by him, but embedded in the brain, etc. Voices and thoughts can give commands, advise something, discuss events, speak vulgarities, make people laugh, etc.

Visual hallucinations develop less frequently and, as a rule, in combination with hallucinations of other types - tactile, gustatory, etc. It is the combination of several types of hallucinations that provides a person with the substrate for their subsequent delusional interpretation. Thus, some unpleasant sensations in the genital area are interpreted as a sign of rape, pregnancy or illness.

It should be understood that for a patient with schizophrenia, his hallucinations are not a figment of the imagination, but he really feels it all. That is, he sees aliens, atmosphere control threads, smells roses from cat litter and other non-existent things.

Rave is a set of certain beliefs, conclusions or conclusions that are completely untrue. Delusions can be independent or provoked by hallucinations. Depending on the nature of the beliefs, delusions of persecution, influence, power, greatness or relationship are distinguished.

The most common delusion of persecution develops, in which a person thinks that someone is chasing him, for example, aliens, parents, children, police, etc. Every small event in the environment seems to be a sign of surveillance, for example, tree branches swaying in the wind are perceived as a sign of observers lying in ambush. The person we meet with glasses is perceived as a liaison who is coming to report all his movements, etc.

Delusions of influence are also very common and are characterized by the idea that a person is being affected by some kind of negative or positive influence, for example, DNA rearrangement, radiation, suppression of will by psychotropic weapons, medical experiments, etc. In addition, with this form of delusion, a person is sure that someone controls his internal organs, body and thoughts, putting them directly into his head. However, the delusion of influence may not take such vivid forms, but masquerade as forms quite similar to reality. For example, a person every time gives a piece of cut sausage to a cat or dog, because he is sure that they want to poison him.

Delusion of dysmorphophobia is a persistent belief in the presence of shortcomings that need to be corrected, for example, straightening protruding ribs, etc. The delirium of reformism is the constant invention of some new powerful devices or systems of relationships, which in reality are unviable.

Inappropriate behavior represents either naive stupidity, or strong agitation, or inappropriate manners and appearance for the situation. Typical types of inappropriate behavior include depersonalization and derealization. Depersonalization is a blurring of the boundaries between me and not me, as a result of which one’s own thoughts, internal organs and body parts seem not to be one’s own, but brought from outside, random people are perceived as relatives, etc. Derealization is characterized by an increased perception of any minor details, colors, smells, sounds, etc. Because of this perception, it seems to a person that everything is not happening for real, but that people, like in a theater, play roles.

The most severe type of inappropriate behavior is catatonia, in which a person takes awkward poses or moves erratically. A person in a stupor usually takes awkward poses and holds them for a very long time. Any attempt to change his position is useless, since he puts up resistance that is almost impossible to overcome, because schizophrenics have incredible muscle strength. A special case of awkward postures is waxy flexibility, which is characterized by holding a part of the body in one position for a long time. When excited, a person begins to jump, run, dance and make other meaningless movements.
Also included in the variant of inappropriate behavior is hebephrenia– excessive foolishness, laughter, etc. A person laughs, jumps, laughs and performs other similar actions, regardless of the situation and location.

Negative symptoms of schizophrenia

In general, negative symptoms of schizophrenia are described as loss of energy and motivation, decreased activity, lack of initiative, poverty of thoughts and speech, physical passivity, emotional poverty and a narrowing of interests. A patient with schizophrenia appears passive, indifferent to what is happening, taciturn, motionless, etc.

However, with a more precise identification of symptoms, the following are considered negative:

• Passivity;
• Loss of will;
• Complete indifference to the outside world (apathy);
• Autism;
• Minimal expression of emotions;
• Flattened affect;
• Slow, sluggish and stingy movements;
• Speech disorders;
• Thinking disorders;
• Inability to make decisions;
• Inability to maintain normal coherent dialogue;
• Low ability to concentrate;
• Rapid depletion;
• Lack of motivation and lack of initiative;
• Mood swings;
• Difficulty in constructing an algorithm for sequential actions;
• Difficulty finding a solution to a problem;
• Poor self-control;
• Difficulty switching from one type of activity to another;
• Ahedonism (inability to experience pleasure).

The speech of a person suffering from schizophrenia is characterized by the following features:

• Constantly jumping on different topics;
• The use of new, invented words that are understandable only to the person himself;
• Repeating words, phrases or sentences;
• Rhyming – speaking in meaningless rhyming words;
• Incomplete or abrupt answers to questions;
• Unexpected silences due to blockage of thoughts (sperrung);
• A rush of thoughts (mentism), expressed in rapid, incoherent speech.

Autism represents a person’s separation from the world around him and immersion in his own little world. In this state, the schizophrenic seeks to avoid contact with other people and live alone.

Various disorders of will, motivation, initiative, memory and attention are generally called depletion of energy potential , because a person gets tired quickly, cannot perceive new things, poorly analyzes the totality of events, etc. All this leads to a sharp decrease in the productivity of his activities, as a result of which, as a rule, he loses his ability to work. In some cases, a person develops an extremely valuable idea, which consists in the need to preserve strength, and which manifests itself in a very careful attitude towards one’s own person.

Emotions in schizophrenia become weakly expressed, and their spectrum is very poor, which is usually called flattened affect . First, the person loses responsiveness, compassion and the ability to empathize, as a result of which the schizophrenic becomes selfish, indifferent and cruel. In response to various life situations, a person can react in a completely atypical and incongruous manner, for example, be absolutely indifferent to the death of a child or be offended by an insignificant action, word, look, etc. Very often a person can experience deep affection and submit to one close person.

As schizophrenia progresses, flattened affect can take on unique forms. For example, a person can become eccentric, explosive, unrestrained, conflictual, angry and aggressive, or, on the contrary, acquire complacency, euphoric high spirits, stupidity, uncriticality of actions, etc. With any variant of flattened affect, a person becomes sloppy and prone to gluttony and masturbation.

Thinking disorders are manifested by illogical reasoning and incorrect interpretation of everyday things. Descriptions and reasoning are characterized by so-called symbolism, in which real concepts are replaced by completely different ones. However, in the understanding of patients with schizophrenia, it is precisely these concepts that do not correspond to reality that are symbols of certain real things. For example, a person walks naked, but he explains it this way: nakedness is needed to remove a person’s stupid thoughts. That is, in his thinking and consciousness, nudity is a symbol of liberation from stupid thoughts.

A special variant of thinking disorder is reasoning, which consists of constant empty reasoning on abstract topics. Moreover, the final goal of the reasoning is completely absent, which makes it meaningless. In severe cases, schizophrenia may develop schizophasia, which is the utterance of unrelated words. Patients often combine these words into sentences, observing the correctness of cases, but they do not have any lexical (semantic) connection.

With a predominance of suppressed will in the negative symptoms, a schizophrenic easily falls under the influence of various sects, criminal groups, and asocial elements, obeying their leaders unquestioningly. However, a person may retain a will that allows him to perform some meaningless action to the detriment of normal work and social interaction. For example, a schizophrenic can draw up a detailed plan of a cemetery with the designation of each grave, count the number of any letters in a particular literary work, etc.

Agedonia represents the loss of the ability to enjoy anything. Thus, a person cannot eat with pleasure, walk in the park, etc. That is, against the background of anhedonia, a schizophrenic, in principle, cannot receive pleasure even from those actions, objects or events that previously gave him pleasure.

Disorganized symptoms

Affective symptoms

Typical syndromes characteristic of schizophrenia

So, Typical positive syndromes of schizophrenia include the following:

• Hallucinatory-paranoid syndrome – characterized by a combination of unsystematized delusional ideas (most often persecution), verbal hallucinations and mental automatism (repetitive actions, the feeling that someone is controlling thoughts and parts of the body, that everything is not real, etc.). All symptoms are perceived by the patient as something real. There is no feeling of artificiality of feelings.
• Kandinsky-Clerambault syndrome – refers to a type of hallucinatory-paranoid syndrome and is characterized by the feeling that all visions and disorders of a person are violent, that someone created them for him (for example, aliens, Gods, etc.). That is, it seems to a person that they are putting thoughts into his head and controlling his internal organs, actions, words and other things. Episodes of mentalism (influx of thoughts) occur periodically, alternating with periods of withdrawal of thoughts. As a rule, there is a completely systematized delusion of persecution and influence, in which a person explains with complete conviction why he was chosen, what they want to do to him, etc. A schizophrenic with Kandinsky-Clerambault syndrome believes that he does not control himself, but is a puppet in the hands of persecutors and evil forces.
• Paraphrenic syndrome – characterized by a combination of persecutory delusions, hallucinations, affective disorders and Kandinsky-Clerambault syndrome. Along with ideas about persecution, a person has a clear conviction of his own power and control over the world, as a result of which he considers himself the ruler of all Gods, the Solar system, etc. Under the influence of his own delusional ideas, a person can tell others that he will create paradise, change the climate, transfer humanity to another planet, etc. The schizophrenic himself feels himself in the center of grandiose, allegedly occurring events. Affective disorder consists of a constantly elevated mood up to a manic state.
• Capgras syndrome- characterized by the delusional idea that people can change their appearance to achieve certain goals.
• Affective-paranoid syndrome – characterized by depression, delusional ideas of persecution, self-accusation and hallucinations with a strong accusatory character. In addition, this syndrome may be characterized by a combination of delusions of grandeur, noble birth and hallucinations of a laudatory, glorifying and approving nature.
• Catatonic syndrome – characterized by freezing in a certain position (catalepsy), giving parts of the body some uncomfortable position and maintaining it for a long time (waxy mobility), as well as strong resistance to any attempts to change the adopted position. Mutism may also be observed - muteness with intact speech apparatus. Any external factors, such as cold, humidity, hunger, thirst and others, cannot force a person to change the absent facial expression with almost completely absent facial expressions. In contrast to freezing in a certain position, agitation may appear, characterized by impulsive, senseless, pretentious and mannered movements.
• Hebephrenic syndrome – characterized by goofy behavior, laughter, mannerisms, grimacing, lisping, impulsive actions and paradoxical emotional reactions. A combination with hallucinatory-paranoid and catatonic syndromes is possible.
• Depersonalization-derealization syndrome – characterized by painful and extremely unpleasant feelings about changes in one’s own personality and the behavior of the surrounding world, which the patient cannot explain.

Typical negative syndromes of schizophrenia are the following:

• Thought disorder syndrome – manifests itself in diversity, fragmentation, symbolism, blockage of thinking and reasoning. Diversity of thinking is manifested by the fact that insignificant features of things and events are perceived by a person as the most important. The speech is detailed with a description of details, but vague and unclear regarding the general main idea of ​​the patient’s monologue. Disruption of speech is manifested by the fact that a person constructs sentences from words and phrases unrelated in meaning, which, however, are grammatically connected by the correct cases, prepositions, etc. A person cannot complete a thought because he constantly deviates from the given topic by association, jumps to other topics, or begins to compare something incomparable. In severe cases, fragmented thinking is manifested by a stream of unrelated words (verbal hash). Symbolism is the use of a term as a symbolic designation for an entirely different concept, thing, or event. For example, with the word stool, the patient symbolically designates his legs, etc. Blocked thinking is a sudden break in the thread of thought or loss of the topic of conversation. In speech, this is manifested by the fact that a person begins to say something, but abruptly falls silent, without even finishing the sentence or phrase. Reasoning is sterile, lengthy, meaningless, but numerous reasoning. In speech, a person with schizophrenia may use their own made-up words.
• Emotional disturbance syndrome – characterized by fading reactions and coldness, as well as the appearance of ambivalence. People lose emotional connections with loved ones, losing compassion, pity and other similar manifestations, becoming cold, cruel and insensitive. Gradually, as the disease progresses, emotions disappear completely. However, it is not always the case that a patient with schizophrenia who does not show emotions is completely absent. In some cases, a person has a rich emotional spectrum and is extremely burdened by the fact that he is not able to fully express it. Ambivalence is the simultaneous presence of opposite thoughts and emotions in relation to the same object. The consequence of ambivalence is the inability to make a final decision and make a choice from possible options.
• Disorder of will syndrome (abulia or hypobulia) – characterized by apathy, lethargy and lack of energy. Such disorders of the will cause a person to isolate himself from the outside world and withdraw into himself. With strong violations of the will, a person becomes passive, indifferent, lacking initiative, etc. Most often, disorders of the will are combined with those in the emotional sphere, so they are often combined into one group and called emotional-volitional disorders. For each individual person, the clinical picture of schizophrenia may be dominated by volitional or emotional disturbances.
• Personality change syndrome is the result of the progression and deepening of all negative symptoms. A person becomes mannered, ridiculous, cold, withdrawn, uncommunicative and paradoxical.

Symptoms of schizophrenia in men, women, children and adolescents

The first symptoms of schizophrenia (initial, early)

• Speech disorders. As a rule, a person begins to answer any questions in monosyllables, even those that require a detailed answer. In other cases, it cannot comprehensively answer the question posed. It’s rare that a person is able to answer a question in full detail, but he speaks slowly.
• Agedonia– inability to enjoy any activities that previously fascinated the person. For example, before the onset of schizophrenia, a person loved to embroider, but after the onset of the disease, this activity does not interest him at all and does not give him pleasure.
• Weak expression or complete absence of emotions. The person does not look into the eyes of the interlocutor, the face is expressionless, no emotions or feelings are reflected on it.
• Inability to complete any task , because a person does not see the meaning in it. For example, a schizophrenic does not brush his teeth because he does not see the point in doing so, because they will get dirty again, etc.
• Poor concentration on any subject.

Symptoms of different types of schizophrenia

Paranoid (paranoid) schizophrenia

Catatonic schizophrenia

Hebephrenic schizophrenia

Simple (mild) schizophrenia

Undifferentiated schizophrenia

Residual schizophrenia

Postschizophrenic depression

In addition to the above, some doctors additionally distinguish manic schizophrenia.

Manic schizophrenia (manic-depressive psychosis)

Depending on the nature of the course, continuous and paroxysmal-progressive forms of schizophrenia are distinguished. In addition, in modern Russia and the former USSR, recurrent and sluggish types of schizophrenia were also distinguished, which in modern classifications correspond to the terms schizoaffective and schizotypal disorder. Let us consider the symptoms of acute (stage of psychosis of paroxysmal-progressive form), continuous and sluggish schizophrenia.

Acute schizophrenia (attacks of schizophrenia) - symptoms

An attack of acute schizophrenia can occur in the form of psychosis or oneiroid. Psychosis is characterized by vivid hallucinations and delusions, complete detachment from reality, delusions of persecution, or depressive detachment and self-absorption. Any fluctuations in mood cause changes in the nature of hallucinations and delusions.

Oneiroid is characterized by unlimited and very vivid hallucinations and delusions that concern not only the world around us, but also oneself. Thus, a person imagines himself as some other object, for example, pockets, a disc player, a dinosaur, a car fighting with people, etc. That is, a person experiences complete depersonalization and derealization. At the same time, within the framework of the delusional-illusory idea of ​​oneself as someone or something that has arisen in the head, entire scenes from the life or activity of that with which the person identified himself are played out. The experienced images cause motor activity, which can be excessive or, on the contrary, catatonic.

Continuous schizophrenia

Sluggish (latent) schizophrenia

Sluggish schizophrenia has the following stages:

• Debut– proceeds unnoticed, as a rule, at puberty;
• Manifest period – characterized by clinical manifestations, the intensity of which never reaches the level of psychosis with delusions and hallucinations;
• Stabilization– complete elimination of manifest symptoms for a long period of time.

Neurosis-like schizophrenia

Alcoholic schizophrenia - symptoms

Alcoholic psychosis can occur in three ways:

• Delirium (delirium tremens) – occurs after stopping the consumption of alcoholic beverages and is expressed in the fact that a person sees devils, animals, insects and other objects or living beings. In addition, the person does not understand where he is and what is happening to him.
• Hallucinosis- Occurs during heavy drinking. The person is bothered by auditory hallucinations of a threatening or accusing nature.
• Delusional psychosis– occurs with prolonged, regular and fairly moderate consumption of alcohol. It is expressed by delusions of jealousy with persecution, attempts at poisoning, etc.

Symptoms of hebephrenic, paranoid, catatonic and other types of schizophrenia - video

Schizophrenia: causes and predisposing factors, signs, symptoms and manifestations of the disease - video

Causes and symptoms of schizophrenia - video

Signs of schizophrenia (how to recognize the disease, diagnosis of schizophrenia) - video