Public Health Problem
Links for Professionals
Delusions / Delusions are false beliefs
about which a person is firmly convinced despite the absence of concrete
evidence. Such false beliefs must be distinguished from culture-specific
beliefs that are held by an entire group or society. People with delusions
may believe they are being persecuted, have special gifts or powers, or
that their thoughts or actions are under the control of an external force.
The delusions may be fantastic or bizarre (e.g., being able to control
the weather or being in communication with aliens from another world).
People holding these false beliefs may be very fearful that they are going
to be harmed or may act in unusual ways because of the beliefs.
Hallucinations / Hallucinations are imagined
sensory perceptions. The most common type of hallucinations that occur
in schizophrenia are auditory in which the person hears imagined voices.
Sometimes people with schizophrenia hold ongoing conversations with these
voices. Sometimes the voices give commands or comment on the character
and actions of the person with schizophrenia. Less common types of hallucinations
include seeing, feeling, tasting, or smelling things that are very real
to the person but which are not actually there. The person may perceive
ordinary colours and shapes in a distorted fashion and feel that they
possess an urgent personal significance.
Thought Disorder / People with thought disorder
have confused thinking that is evident in what they say and how they say
it. The person's speech may be difficult to follow because it jumps from
one subject to another with little or no logical connection. Interruptions
in the train of thought (thought blocks) may occur. The syntax may be
bizarre and appear to make sense only to the speaker. In some cases, people
believe their thoughts are being broadcast or stolen from them, or that
their thoughts are being controlled or influenced by an external agent
(e.g., an alien, a demon). These phenomena are referred to as thought
echo, broadcasting, insertion, or withdrawal. In severe cases, speech
may be so jumbled and disjointed that it is impossible to understand.
Bizarre Behaviour / Some people with schizophrenia
behave in strange ways or transgress social mores (e.g., undressing in
public). They may make odd gestures or incongruous facial expressions
and grimaces or assume strange postures for no apparent purpose.
Positive symptoms are relatively easy to recognise
because they are so obviously different from normal. However, the presence
of positive symptoms such as hallucinations and delusions does not necessarily
mean that the person has schizophrenia. These same symptoms may also occur
in people who abuse alcohol or drugs or who have severe depression, mania,
brain injury, or certain medical illnesses.
Because prominent positive symptoms make
it very difficult for the person to function socially, they often result
in admission to a psychiatric hospital. Fortunately, antipsychotic medication
can eliminate or reduce the intensity of positive symptoms and lessen
the chance that they will recur, although the person may still be affected
by negative symptoms. A relapse can occur if the person experiences a
stressful life event, long-term stressful relationship, or if medications
are stopped or the dosage reduced. Relapses can also occur without any
apparent trigger even when the person has continued to take a dosage of
medication that was previously adequate.
People with schizophrenia may speak and
behave in odd or bizarre ways that cause others to fear and avoid them,
thus perpetuating the stigma associated with the disorder.
The difficulty that individuals with schizophrenia
have in communicating verbally may contribute to the stigma associated
with the disorder.
Positive symptoms are associated with the
kind of stigma attached to madness. Delusions, hallucinations, disturbed
behaviour, and an altered perception of reality are characteristic of
those who are considered "crazy" by lay persons. The strange
behaviour of those with schizophrenia raises the fear among others that
they may lose control of their own behaviour.