There is a spectrum of psychotic disorders, and schizophrenia is one of the diso
There is a spectrum of psychotic disorders, and schizophrenia is one of the disorders on the spectrum. Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. It also affects the person’s ability to recognize their symptoms as problematic, referred to as a “lack of insight.” Continuous signs of the disturbance must be present for at least six months in order for schizophrenia to be diagnosed, and potential medical conditions that could be causing delirium must be ruled out.[1],[2]
Schizophrenia is typically diagnosed in the late teen years to the early thirties and tends to emerge earlier in males than females. A diagnosis of schizophrenia often follows the first episode of psychosis when individuals first display symptoms of schizophrenia. Gradual changes in thinking, mood, and social functioning often begin before the first episode of psychosis, usually starting in mid-adolescence. (See “Early Signs of Psychosis” in the previous section.) Schizophrenia can occur in younger children, but it is rare for it to occur before late adolescence.[3]
Symptoms of Schizophrenia
Symptoms of schizophrenia are classified by three categories: positive, negative, and cognitive.[4]
- Positive symptoms: Positive symptoms include hallucinations, delusions, thought disorders, disorganized speech, and alterations in behaviors. Read more about delusions and hallucinations in the “Thoughts and Perceptions” subsection of the “Assessment” section of the “Application of the Nursing Process in Mental Health Care” chapter. The most common types of delusions experienced by individuals with schizophrenia are paranoia, persecutory, grandiose, or religious ideas. For example, an individual with persecutory delusions may feel the nursing staff is trying to poison them when they administer medications. People with psychotic symptoms lose a shared sense of reality and experience the world in a distorted way.[5]
- Negative symptoms: Negative symptoms refer to loss of motivation, disinterest or lack of enjoyment in daily activities, social withdrawal, difficulty showing emotions, and difficulty functioning normally. Individuals typically experience the following negative symptoms[6]:
- Reduced motivation and difficulty planning, beginning, and sustaining activities (i.e., avolition)
- Diminished feelings of pleasure in everyday life (i.e., anhedonia)
- Flat affect (i.e., reduced expression of emotions via facial expression or voice tone)
- Reduced speaking
- Cognitive symptoms: Cognitive symptoms refer to problems in attention, concentration, and memory. For some individuals, the cognitive symptoms of schizophrenia are subtle, but for others, they are more prominent and interfere with activities like following conversations, learning new things, or remembering appointments. Individuals typically experience symptoms such as these[7]:
- Difficulty processing information to make decisions
- Problems using information immediately after learning i