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People with schizophrenia may have perceptions of reality that are strikingly different from the reality seen and shared by others around them. Living in a world distorted by hallucinations and delusions, individuals with this condition may feel frightened, angry, anxious , depressed , or confused.
Symptoms of schizophrenia usually start in adolescence or early adulthood. They often appear slowly and become more pronounced, disturbing, and bizarre over time. The first signs of schizophrenia often appear as confusing—or even shocking—changes in behavior. To fit the diagnostic criteria, symptoms of the illness must be present for at least six months, and there must be deterioration from the patient’s previous level of functioning.
The sudden onset of severe psychotic symptoms is referred to as an acute phase of schizophrenia. Psychosis, a common condition in schizophrenia, is a state of mental impairment marked by hallucinations. Less obvious symptoms (such as social isolation and/or withdrawal, unusual speech, bizarre thinking, or strange behavior) may precede, coincide, or follow the psychotic symptoms.
Individuals with schizophrenia may behave differently at unpredictable times. This unusual behavior usually occurs as a result of the unusual realities they are experiencing. People with this condition may seem distant, detached, or preoccupied. They may be very restless and/or hypervigilant and unable to sit or stand still, or sit as rigidly as a stone (catatonia) without moving or speaking for hours.
Common symptoms of schizophrenia include:
Some people have only one psychotic episode. Others have many episodes during a lifetime, but lead relatively normal lives between these periods. An individual with chronic schizophrenia, with a continuous or recurring pattern of illness, often does not fully recover normal functioning. He typically requires long-term treatment, which generally includes medication, to control the symptoms.
People with schizophrenia do not always act abnormally. Indeed, some people with the illness can appear completely normal even while they experience hallucinations or delusions. A person’s behavior may change over time—often becoming strange or bizarre if medication is stopped, then returning closer to normal when receiving and complying with appropriate treatment.
References:
Carson RC, Butcher JN, Mineka S. Abnormal Psychology and Modern Life. 11th ed. Boston, MA: Allyn and Bacon; 2000.
DelBello M, Grcevich S. Phenomenology and epidemiology of childhood psychiatric disorders that may necessitate treatment with atypical antipsychotics. J Clin Psychiatry. 2004;65(suppl 6):12-19.
Keshavan MS, Roberts M, Wittmann D. Guidelines for clinical treatment of early course schizophrenia. Curr Psychiatry Rep. 2006;8:329-334.
National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ .
Last reviewed March 2009 by Rosalyn Carson-DeWitt, MD
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