Schizophrenia

Definition

On some occasions, individuals may endure subjective, fleeting psychotic experiences. These isolated occurrences alone are not necessarily indicative of schizophrenia. Amongst individuals with schizophrenia, a wide multitude of symptoms are present. These comprehensive symptoms result in marked impairments in cognitions and cause significant issues with overall psychosocial functioning.

Psychosis vs. Psychotic Disorder

Please note that "psychosis" itself is not a diagnosis and may be differentiated from "psychotic disorders". Psychosis is not an illness, but rather, a symptom. It is a term that is utilized to describe a range of out-of-the-ordinary or abnormal experiences that may result from a range of mental or physical factors. When experiencing extreme adversity, members of the general population may endure fleeting periods of psychosis. Psychotic disorders, on the other hand, refer to a range of mental health conditions (disorders). This chapter of our Library will refer to one such condition that falls under the umbrella of psychotic disorders, schizophrenia.

Gentle claymation figure seated calmly in reflective awareness, illustrating clinical features of schizophrenia

Positive Symptoms

What are "Positive" Symptoms?

Delusions
Hallucinations
Experiences of Passivity and Control
Disorganized Thought patterns (that typically manifest as disorganized speech)
Disorganized Behaviour

What are hallucinations?

Hearing, feeling, tasting, smelling or feeling things that primarily exist within one’s mind. For instance;

Hearing someone telling you to do something when there is no one in sight

What are delusions?

Untrue beliefs or convictions. For instance, this may include:

The belief that one is God
The belief of being chased or traced by the police

Negative Symptoms

What are "Negative" Symptoms?

Flattened emotions
Avolition: Lacking motivation (for instance, not eating, not being able to get changed or brush one’s teeth)
Alogia: For instance, difficulty speaking or verbalizing
Demonstrating asociality
Inability to feel pleasure

Claymation woman figure paused thoughtfully on a pathway, illustrating cognitive perplexity and multi-modal symptoms

Comorbidities

Comorbidities introduce a greater overall symptom burden. Common conditions that frequently appear alongside schizophrenia include:

Mood disorders (such as Depression)
Anxiety disorders

Claymation student sitting quietly with a sketchbook, depicting developmental course and prodromal emergence

Variability

Sex and Gender-Related Differences
- Females: Usually demonstrate a higher presentation of positive symptoms, which can increase over the course of their life. They are also more prone to experiencing mood disturbances and co-occurring conditions. However, compared to males, females demonstrate a lower tendency to exhibit symptoms indicative of disorganized thinking and social impairment.
- Males: Show a higher tendency to exhibit symptoms related to disorganized thinking and experience more severe forms of baseline social impairment.
Age-Related Differences
- Childhood Rarity: Onset of the condition is exceedingly rare in childhood. Children and adolescents who do endure the condition typically experience pronounced issues across social, language, and motor development.
- Magical Thinking Overlap: Given their developmental affinity for "magical thinking," children are uniquely prone to demonstrating severe difficulty differentiating between the consequences of real-world life events (such as being bullied) and internal voices they perceive as originating from a monster or an imaginary friend.

Important note: Many people with Schizophrenia do not recognize that their disturbances, delusions, or hallucinations are symptoms of a health condition. Assessment by a qualified mental health professional is important to determine whether the symptoms meet the criteria for Schizophrenia within the individual’s cultural and life context.

Claymation figure standing at diverging paths, illustrating multifactorial neurodevelopmental and environmental etiology

Claymation figure stepping forward with support and hope, representing psychosocial rehabilitation and recovery

Clinical Perspectives & Reminder

We sincerely appreciate your dedication; you have made it through this section of our IndoPsyCare library. We trust that you have gleaned valuable information from this page. Before we part ways we would like to reiterate the importance of refraining from diagnosing yourself, or other individuals, based on the information provided. If you feel as though you or others are experiencing this condition, we implore you to seek professional help.

Bibliography

Fulford, D., Niendam, T. A., Floyd, E. G., Carter, C. S., Mathalon, D. H., Vinogradov, S., Stuart, B. K., & Loewy, R. L. (2013). Symptom dimensions and functional impairment in early psychosis: more to the story than just negative symptoms. Schizophrenia research, 147(1), 125–131. https://doi.org/10.1016/j.schres.2013.03.024

Heilbronner, U., Samara, M., Leucht, S., Falkai, P., & Schulze, T. (2016). The Longitudinal Course of Schizophrenia Across the Lifespan. Harvard Review Of Psychiatry, 24(2), 118-128. doi: 10.1097/hrp.0000000000000092

Stilo, S.A., Murray, R.M. Non-Genetic Factors in Schizophrenia. Curr Psychiatry Rep 21, 100 (2019). https://doi.org/10.1007/s11920-019-1091-3

Ohi, K., Shimada, T., Nitta, Y., Kihara, H., Okubo, H., Uehara, T., & Kawasaki, Y. (2016). The Five-Factor Model personality traits in schizophrenia: A meta-analysis. Psychiatry research, 240, 34–41. https://doi.org/10.1016/j.psychres.2016.04.004

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