Sentiens Health

Positive symptoms:

These symptoms tend to be the active psychotic symptoms that interfere with the persons reality. They comprise delusions, thought disorder and hallucinations.

Delusions

Delusions are false, usually strange personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person’s usual cultural concepts, and cannot be changed by argument. Delusions may take on different themes, for example, patients suffering from paranoid-type symptoms. About one-third of people with schizophrenia have delusions of persecution, or false and irrational beliefs that they are being cheated, harassed, poisoned, or conspired against. These patients may believe that they, or a member of their family or someone close to them, are the focus of this persecution. In addition, delusions of grandeur, in which a person may believe he or she is a famous or important figure, may occur in schizophrenia. Sometimes the delusions experienced by people with schizophrenia are quite bizarre; for instance, believing that a neighbour is controlling their behavior with magnetic waves; that people on television are directing special messages to them; or that their thoughts are being broadcast aloud to others. On the other hand, delusions may be somewhat awesome - 'I'm God's messenger!' 'I'm the richest person in the world!' 'I'm persecuted by men from Mars!' - or apparently reasonable - 'My husband is unfaithful'. 'Everyone at work is against me'. Persecutory delusions are especially distressing for the family if they are seen as the persecutors. Delusions may come out of the blue or may start as an explanation for hallucinations or the sensation of being taken over.  Often, unless they are uncovered and treatment started early, delusions evolve and become more elaborate over time, gradually encompassing more people, places, things and events, as the person becomes more ill and engrossed in their perception of reality.

Disordered Thinking

Schizophrenia often affects a person’s ability to think logically. Thoughts may come and go rapidly. The person may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention.

People with schizophrenia may not be able to sort out what is relevant and what is not relevant to a situation. The person may be unable to connect thoughts into logical sequences, with thoughts becoming disorganized and fragmented. This lack of logical continuity of thought, termed ‘thought disorder’, can make conversation very difficult and may contribute to social isolation. If people cannot make sense of what an individual is saying, they are likely to become uncomfortable and tend to leave that person alone.

Hallucinations and Illusions

The word hallucination, refers to disturbances of perception that cause the person to hear, smell, feel or see something, without there actually being anything there to hear, smell, feel or see. Hallucinations and illusions are common in people suffering from schizophrenia. The voices sound so real that the hearer is convinced that they come from outside, perhaps from hidden microphones, loudspeakers, or the spirit world. Voices are sometimes heard in some other mental illnesses, but in schizophrenia they typically talk about, as well as to, the person. As mentioned, hallucinations can occur in any sensory form whether this is auditory (sound), visual (sight), tactile (touch), gustatory (taste), and olfactory (smell). Hearing ‘voices’ that other people do not hear is the most common type of hallucination in schizophrenia. Voices may describe the patient’s activities, carry on a conversation, warn of impending dangers, or even issue orders to the individual. Illusions, on the other hand, occur when a sensory stimulus is present but is incorrectly perceived and interpreted by the individual.

Speech and behaviour

Sometimes schizophrenia interferes with a person's train of thought, so it may be difficult to follow what they say. Emotions and behaviour may be affected by hallucinations. This may be talking or shouting back at the 'voices', or carrying out the instructions (which may even mean self-harm or suicide). False beliefs may not affect behaviour but persecutory delusions may lead to the person accusing members of their family or strangers and, rarely, to attacks which may be dangerous. When such incidents occur they understandably cause much concern and distress for all involved.
News and entertainment media tend to link mental illness and criminal violence. However, studies indicate that except for those persons with a record of criminal violence before becoming ill, and those with substance abuse or alcohol problems, people with schizophrenia are not especially prone to violence. Most individuals with schizophrenia are not violent; more typically, they are withdrawn and prefer to be left alone. The vast majority of violent crimes are not committed by persons with schizophrenia, and most persons with schizophrenia do not commit violent crimes. Substance abuse significantly raises the rate of violence in people with schizophrenia but also in people who do not have any mental illness. People with paranoid and psychotic symptoms, which can become worse if medications are discontinued, may also be at higher risk for violent behavior. When violence does occur, it is most frequently targeted at family members and friends, and more often takes place at home. The person with schizophrenia is not a ‘split personality’. Schizophrenia is the name given to a set of characteristic symptoms.