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Symptoms and Sub-types
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Prodromal and Residual Symptoms of Schizophrenia
Prior to the onset of acute symptoms, (and not due to mood disturbance or substance abuse) and following an acute episode, many patients exhibit less dramatic symptoms.
- Marked social isolation and withdrawal.
- Impairment in social role e.g. as a wage earner or student.
- Peculiar eccentric behaviour.
- Poor personal hygiene.
- Blunted or inappropriate affect.
- Vague speech.
- Odd beliefs.
- Unusual perceptual experiences.
- Lack of initiative or energy.
Summary of the Symptoms of Schizophrenia
The symptoms of schizophrenia can therefore be divided into positive symptoms, seen during acute phases of the illness, and negative symptoms, which are more chronic and responsible for the long term social impairment of patients with chronic schizophrenia.
Positive features of schizophrenia:
- Hallucinations
- Delusions
- Ideas of reference
- Thought disorder - abnormal patterns of thought reflected in speech. Characterised by the breakdown of normal associations. The associations are often incomprehensible to the listener.
Negative features of schizophrenia:
- Social withdrawal.
- Emotional blunting.
- Underactivity.
- Lack of motivation.
Subtypes of Schizophrenia
Four subtypes of schizophrenia have been described where particular clinical patterns have been observed.
- Simple Schizophrenia. Negative symptoms predominate.
- Hebephrenic schizophrenia. Mood is inappropriate with giggling and shallowness, behaviour is irresponsible. Delusions and hallucinations are fragmented. Thoughts are disorganised. Onset typically age 15-25.
- Paranoid schizophrenia. Complex delusions and hallucinations. Delusions may be persecutory, grandiose or religious.
- Catatonic schizophrenia. Psychomotor disturbance varying from stupor to sudden outbursts of activity. Waxy flexibility, automatic obedience and negativism.
Schizoaffective disorder
This diagnosis should be limited to cases where diagnostic criteria for both schizophrenia and a mood disorder occur during the same episode. Otherwise the diagnosis is of the predominant syndrome.
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