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page 3.  Schizophrenia:  Understanding the Disorder


                What are the symptoms? 


        Symptoms of schizophrenia are divided into “positive” and “negative” categories.  This can be confusing.  “Positive” are those characteristics that are present, and should be absent.  “Negative” are those that are absent, and should be present. 


        If you or someone you know suffers from schizophrenia, some or all the following symptoms may be present.  The expression of these symptoms varies greatly from one individual to another.  No one symptom is common to all people. 


                Negative symptoms:


a)      Blunted Affect

b)      Emotional withdrawal

c)       Poor rapport

d)      Passive/apathetic/social withdrawal

e)      Difficulty in abstract thinking

f)        Lack of spontaneity

g)      Stereotyped thinking


Positive symptoms:


a)      Delusions

b)      Hallucinations

c)       Thought disorders

d)      Excitement

e)      Grandiosity

f)        Suspiciousness/persecution

g)      Hostility


                Negative Symptoms (the more inward signs):


        Negative symptoms may appear early and can be the initial signs of schizophrenia.  Parents may notice that a child who was once a “go-getter” has become withdrawn from family and friends, has lost interest in their usual activities,  and has become unfeeling.


        It can become very difficult for a parent to decide whether something is really wrong with their child because the “adolescent experience” that many teenagers go through can involve similar periods of withdrawal or moodiness.


                        Neg-sym1:  Blunted emotion or blunted affect:

                                For the person with schizophrenia life can be devoid of feeling.  Individuals may say they feel less connected emotionally to what is going  on around them,  and they may appear less responsive on an emotional level to their surroundings.


                                Alternatively, the individual may respond with  inappropriate emotions because of the other things going on in his or her head – like suddenly breaking out in  a fit of laughter for no apparent reason, or when hearing sad or distressing news. 


                        Neg-sym2:  Emotional withdrawal:

                                Individuals may be detached and uncommunicative.  They have few interests and few personal relationships.


                        Neg-sym3:  Poor rapport:

                                In general, the person may avoid eye contact with you.  In conversation, they may appear bored, indifferent, lacking in warmth.


                        Neg-sym4:  Passive/apathetic:

                                For the individual with schizophrenia, there may be lack of interest or concern for their surroundings.  A lack of energy and drive makes it difficult for them to complete simple tasks, and they are sometimes able to do little more than sleep or eat.  They may appear to seek or want nothing.  To those around them, they may appear lazy and sluggish.  But this is the disorder at work.  It is as though some central drive mechanism that is normally present in most of us is missing. 


                        Neg-sym5:  Social Withdrawal:

                                The person with schizophrenia may spend most time alone because he or she feels safer and calmer;  or they are so absorbed in their own thoughts/senses that they lose interest in the feelings and lives of others.


                        Neg-sym6:  Difficulty in abstract thinking:

                                Many people with schizophrenia can only think in concrete terms.  They are unable to see beyond details to the underlying meaning, unable to move from the specific to the general.


                        Neg-sym7:  Lack of spontaneity:

                                There may be a hesitancy in the speech or action of individuals.  Some people with schizophrenia have decreased spontaneous movements or they may become very unnatural in their movements.


                        Neg-sym8:  Stereotyped thinking:

                                Persons with schizophrenia can hold very rigid attitudes and beliefs that may seem unreasonable to those around them.  Repetitive thoughts may intrude and interfere with their thinking.


                        Neg-sym9:  Physical symptoms:

                                Physical activity for the disordered individual may slow down.  In severe cases, activity may stop to the point where the person sits motionless and  stares into space for long periods of time.  Individuals may be unconcerned with grooming and hygiene and appear untidy.


                The negative symptoms can prevent patients from being able to hold a  job, or have a normal social life.  When the symptoms are severe, it may  be difficult for them to do even the simple things like grocery shopping, showering or just looking after themselves.


                It was previously believed that this group of symptoms, the negative symptoms, were side effects of the antipsychotics used to treat schizophrenia.  These “side effects” are often seen by caregivers and even people with the disorder as the “price you pay” for controlling the hallucinations, delusions, and paranoia.  But we now know that this may not be the case.  For some people, these symptoms  may be part of the disorder itself.  So, a person with schizophrenia may not be able to help their lack of interest, motivation, and energy.