Schizophrenia - Symptoms & diagnosis
What are the symptoms of schizophrenia and how is it diagnosed?
There are no blood tests or scans that can prove if you have schizophrenia. Only a psychiatrist can diagnose you after a full psychiatric assessment. Psychiatrists use manuals to diagnose mental illnesses. The main manuals used by doctors are the:
- International Classification of Diseases (ICD-10) which is produced by the World Health Organisation (WHO)
- Diagnostic and Statistical Manual (DSM-5) which is produced by the American Psychiatric Association.
NHS doctors use the ICD-10.
The manuals explain which symptoms should be present, and for how long.Your symptoms need to last for a least one month before your doctor can diagnose you. They may say you have a psychotic disorder or psychosis before they diagnose you with schizophrenia.
Sometimes the symptoms of schizophrenia are described as positive symptoms or negative symptoms. This does not mean that they are good or bad.
‘Positive’ symptoms are experienced in addition to reality. ‘Negative’ symptoms can effect your ability to function.
The terms ‘positive symptoms’ and ‘psychosis’ are generally used to describe the same symptoms. The following are positive symptoms.
- Disorganised thinking
These are experiences that are not real or that other people do not experience. Hallucinations can affect all of your senses which are:
- auditory (sound),
- visual (sight),
- tactile (touch),
- gustatory (taste) and
- olfactory (smell)
Hearing voices or other sounds is the most common hallucination. Hearing voices is different for everyone.
For example, voices may be:
- female or male,
- someone you know or someone you’ve never heard,
- in a different language or different accent to your own,
- whispering or shouting, or
- negative and disturbing.
You might hear voices every now and then or all of the time.
Delusions are fixed beliefs which do not match up to the way other people see the world. You may not be able to find evidence for or against your belief, and you may look for ways to prove the way you see things.
Delusions may include believing different things such as the following:
- you are being chased, plotted against or poisoned,
- someone you know, the government or aliens are responsible,
- you are a famous or important person,
- people on television are sending messages to you, or
- your thoughts are being broadcast aloud.
You may feel overwhelmed and act differently due to your beliefs.
Another symptom is ‘disorganised thinking’. This means you might start talking quickly or slowly. The things you say might not make sense to other people. You may switch topics without any obvious link. This is sometimes known as ‘word salad’.
A diagnosis of schizophrenia does not mean that you will have all these symptoms. The way that your illness affects you will depend on the type of schizophrenia that you have. For example, not everyone with this diagnosis will have hallucinations or confused thinking.
These are symptoms that involve loss of ability and enjoyment in life. They can include the following things:
- Lack of motivation
- Slow movement
- Change in sleep patterns
- Poor grooming or hygiene
- Difficulty in planning and setting goals
- Not saying much
- Changes in body language
- Lack of eye contact
- Reduced range of emotions
- Less interest in socialising or hobbies and activities
- Low sex drive
Another negative symptom is cognitive impairment. This means that your mind is affected in a negative way.
Cognitive experiences are ones that relate to mental action; such as learning, remembering and functioning.
Some cognitive experiences are associated with schizophrenia are:
- being unable to sustain attention,
- memory problems,
- Unable to take on information, and
- Poor decision making
Negative symptoms are much less dramatic than positive symptoms. They may last longer, and stay after positive symptoms fade away. Many people with schizophrenia feel that the negative symptoms of their illness are more serious than the positive symptoms. Negative symptoms can vary in severity.
You can find more information on ‘Psychosis’ here.
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