Cognitive Symptoms & Thinking Problems
These symptoms reflect how well the personâs brain learns, stores, and uses information.
Someone with schizophrenia might have a hard time with their working memory. For example, they may not be able to keep track of different kinds of facts at the same time, like a phone number plus instructions.
Along with having trouble paying attention, it can be hard for them to organize their thoughts and make decisions.
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What Are The Types Of Schizophrenia
There are different types of schizophrenia. The International Classification of Diseases manual describes them as below.
Paranoid schizophrenia
- Pranks, giggling and health complaints.
- Usually diagnosed in adolescents or young adults.
Catatonic schizophrenia
- Unusual movements, often switching between being very active and very still.
- You may not talk at all.
Simple schizophrenia
- Negative symptoms are prominent early and get worse quickly.
- Positive symptoms are rare.
Undifferentiated schizophrenia
Your diagnosis may have some signs of paranoid, hebephrenic or catatonic schizophrenia, but doesnt obviously fit into one of these types alone.
Residual schizophrenia
This type of schizophrenia is diagnosed in the later stages of schizophrenia. You may be diagnosed with this if you have a history of schizophrenia but only continue to experience negative symptoms.
Other schizophrenia
There are other types of schizophrenia according to the ICD-10, such as.
- Cenesthopathic schizophrenia. This is where people experience unusual bodily sensations.
- Schizophreniform. Schizophreniform disorder is a type of psychotic illness with symptoms similar to those of schizophrenia. But symptoms last for a short period.
Unspecified schizophrenia
Symptoms meet the general conditions for a diagnosis, but do not fit in to any of the above categories.
What Can I Do If A Loved One Shows Signs Of Schizophrenia Or A Similar Condition
Because people with schizophrenia often cant recognize their symptoms or condition, they often dont believe they need medical care or treatment. That can be frustrating or frightening for both the person with the symptoms and those who care about them.
If you notice a loved one showing signs of schizophrenia or a related condition, you can try helping them by doing the following:
A note from Cleveland Clinic
Schizophrenia can be a frightening condition for the people who have it and their loved ones. Despite stereotypes, this isnt a condition where any thought of recovery or living a happy, fulfilling life is impossible. If you think you have symptoms of schizophrenia, its important to talk to a healthcare provider as soon as you can. Their job is to help you, and healthcare providers especially those who specialize in mental health conditions like schizophrenia have the training to help you not feel judged, ashamed or embarrassed. If you notice a loved one struggling with symptoms of psychosis or schizophrenia, encourage them gently and supportively to get care. Early diagnosis and treatment can make a big difference in helping people recover and manage this condition.
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Statement Of Need And Purpose
The goals of schizophrenia treatment are to control symptoms, prevent relapse, and improve functioning and quality of life. For many patients, these goals are not met, and as a result, recovery rates in schizophrenia have not improved. Over the last 70 years, the treatment efficacy landscape has not changed. Antipsychotic medications are effective in treating the positive symptoms but have little to no effect on cognitive or negative symptoms. Additionally, although side effects of antipsychotics can reduce patient adherence to medication, many clinicians underestimate the impact of adverse effects such as weight gain to adherence and do not routinely provide recommended monitoring. Furthermore, many clinicians support the use of a patient-centered approach to schizophrenia treatment, but evidence suggests that it does not routinely occur. To better recognize and address patients unmet needs, clinicians need education on a patient-centered approach, symptom domains, adverse effects, and the potential impact of novel treatments. Novel oral medications have been approved by the FDA recently and others are in late-stage development these treatments have novel mechanisms of action or are combinations of agents that may offer efficacy for cognitive and negative symptoms and improved adherence due to more favorable adverse event profiles.
Lack Of Emotional Expressions
A characteristic symptom of schizophrenia is a lack of emotional expression. People with this condition may show little or no reactions to good or bad news.
They also begin to show fewer facial expressions and gestures when they talk. Their voice may become flat when they speak.
Interestingly, suggests that while they appear to have a wooden expression, what they express outward may not be the same as what they feel inside.
Sometimes, they can have unexplained and seemingly inappropriate reactions to things, like overwhelming anger or inappropriate laughter.
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Negative Symptoms Of Schizophrenia: How To Treat Them Most Effectively
Current Psychiatry
Clinical associate professor of psychiatry
. . .
University of Michigan Medical School Ann Arbor
Disclosure
Dr. Tandon reports that he serves on the speakers bureau and as a consultant to Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb Co., Eli Lilly and Co., Janssen Pharmaceutica, Novartis, and Pfizer Inc. Dr. Jibson reports that he serves on the speakers bureau of AstraZeneca, Janssen Pharmaceutica, and Pfizer Inc.
Schizophrenias negative symptoms have traditionally been viewed as treatment-resistant, but they do respond to pharmacologic and social interventions. The benefitseven when modestcan and do make a difference in patients lives.
Positive Symptoms Of Schizophrenia
Positive symptoms of schizophrenia are ones that are atypically present, as they can disrupt a persons grasp of reality. Some mental health professionals also collectively refer to these symptoms as psychosis. Positive symptoms are experienced on a more active basis.
Consider the most common positive symptoms of schizophrenia:
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What If I Am Not Happy With My Treatment
If you are not happy with your treatment you can:
- talk to your doctor about your treatment options,
- ask for a second opinion,
- get an advocate to help you speak to your doctor,
- contact Patient Advice and Liaison Service and see whether they can help, or
- make a complaint.
There is more information about these options below.
Treatment options
You should first speak to your doctor about your treatment. Explain why you are not happy with it. You could ask what other treatments you could try.
Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you are not given this treatment, ask your doctor to explain why it is not suitable for you.
Second opinion
A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.
You dont have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.
Advocacy
An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard.
There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like.
The Patient Advice and Liaison Service
Complaints
You can find out more about:
How To Manage And Cope With Symptoms Of Schizophrenia
Managing schizophrenia is a lifelong process that requires a combination of medications and therapies to help minimize the effects that some symptoms may have on your everyday life. Social skills and life-management skills classes can also help you develop more independence and confidence.
Its also important to have a support system. This may include family or loved ones, friends, or people you might meet in group therapy. You can also talk with your doctor if youre concerned about any new or worsening symptoms.
Finally, its important to take care of yourself. A balanced diet, regular exercise, and relaxation techniques can all promote well-being and decrease stress.
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What Can I Do To Manage Schizophrenia
People deal with their experience in different ways. You might need to try different things before finding something that works.
Support groups
You could join a support group. A support group is where people come together to share information, experiences and give each other support. Hearing about the experiences of others can help you feel understood. This may help you feel less alone and boost your self-confidence.
You might be able to find a local group by searching online. Rethink Mental Illness have support groups in some areas. You can find out what is available in your area, or get help to set up your own support group if you follow this link:
Or you can call our advice service on 0808 801 0525 for more information.
Recovery College
Recovery colleges are part of the NHS. They offer free courses about mental health to help you manage your experiences. They can help you to take control of your life and become an expert in your own wellbeing and recovery. You can usually self-refer to a recovery college. But the college may tell your care team.
Unfortunately, recovery colleges are not available in all areas. To see if there is a recovery college in your area you can use a search engine such as Google. Or you can call our advice service on 0808 801 0525 for more information.
Peer support through the NHS
- recognising and coping with symptoms,
- what to do in a crisis,
- meeting other people who can support you, and recovery.
Self-management techniques
- talk back to them,
How Does This Condition Affect My Body
Schizophrenia is a condition that has severe effects on a persons physical and mental well-being. This is because it disrupts how your brain works, interfering with your thinking ability, memory, how your senses work and more.
Because your brain isnt working correctly, having schizophrenia often causes you to struggle in many parts of your day-to-day life. Schizophrenia often disrupts your relationships . It can also cause you to have trouble organizing your thoughts, and you might behave in ways that put you at risk for injuries or other illnesses.
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How Do I Take Care Of Myself
People with schizophrenia should do the following to help care for themselves and manage their condition:
- Take medications as prescribed. One of the most critical things a person with schizophrenia can do to help themselves is to take their medications. If you have schizophrenia, you should not stop your medication without talking to your healthcare provider. Sudden stopping of medication often speeds up the return of psychosis symptoms. Side effects are common with antipsychotics. However, there are many antipsychotic medications, so its often possible to work with your healthcare provider to find one that both works well for you and has minimal or no side effects.
- See your healthcare provider as recommended. Your healthcare provider will set up a schedule for you to see them. These visits are especially important to help with managing your condition.
- Dont ignore or avoid symptoms. Schizophrenia is more likely to respond and have a good outcome with early diagnosis and treatment.
- Avoid alcohol and recreational drug use. Alcohol and drug use can make schizophrenia symptoms worse and can lead to other issues. This includes using prescription medications in a way other than prescribed.
- Consider seeking support. Organizations such as the National Alliance on Mental Illness can offer resources and information that can help.
What Myths Are There About Schizophrenia
There are some myths or mistaken beliefs about schizophrenia which come from the media. For example,
- Schizophrenia means someone has a split personality
This is not the case. The mistake may come from the fact that the name ‘schizophrenia’ comes from two Greek words meaning ‘split’ and ‘mind’.
- People who live with schizophrenia are dangerous
Those who live with schizophrenia arent usually dangerous. People who live with schizophrenia are far more likely to be harmed by other people than harm others.
There is a higher risk of violent behaviour from those who live with schizophrenia. But, as with people who dont live with schizophrenia, much of the risk is linked to the use of street drugs or alcohol.
Sometimes people who live with schizophrenia commit violent crimes. The media often report them in a way which emphasises the persons mental health diagnosis. This can create fear and stigma in the general public. But it should be remembered that:
- violent crimes are also committed by people who dont live with schizophrenia,
- its often later found that the person was failed or neglected by the mental health system, and
- the crime might have been prevented if the person had received the care and support they needed.
So, its not right to say that schizophrenia equals dangerous.
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Negative Symptoms Of Schizophrenia
The negative symptoms of schizophrenia can often appear several years before somebody experiences their first acute schizophrenic episode.
These initial negative symptoms are often referred to as the prodromal period of schizophrenia.
Symptoms during the prodromal period usually appear gradually and slowly get worse.
They include the person becoming more socially withdrawn and increasingly not caring about their appearance and personal hygiene.
It can be difficult to tell whether the symptoms are part of the development of schizophrenia or caused by something else.
Negative symptoms experienced by people living with schizophrenia include:
- losing interest and motivation in life and activities, including relationships and sex
- lack of concentration, not wanting to leave the house, and changes in sleeping patterns
- being less likely to initiate conversations and feeling uncomfortable with people, or feeling there’s nothing to say
The negative symptoms of schizophrenia can often lead to relationship problems with friends and family as they can sometimes be mistaken for deliberate laziness or rudeness.
What Are The Different Types Of Schizophrenia
Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Schizophrenia is a chronic mental health condition that interferes with a person’s perception of reality. People with schizophrenia have difficulty with emotions, thinking rationally and clearly, and in interactions and relationships with others.
Verywell / Cindy Chung
Until the most recent version of the Diagnostic and Statistical Manual of Mental Disorders was published in 2013, schizophrenia was officially recognized as having five distinct subtypes.
Because the symptoms of these subtypes were not felt to be reliable or consistently valid, the American Psychiatric Association determined that having distinct subtypes hindered diagnosis and removed them when they published the DSM-5.
Although they are no longer used for diagnostic categorization, some mental health professionals still find these subtypes useful for understanding the ways in which schizophrenia can present. This nuanced understanding can help determine the best ways to approach treatment plans.
As we look at the different subtypes of schizophrenia, it is important to keep in mind that the symptoms of these subtypes overlap with other disorders, and that to be diagnosed with schizophrenia, a person must meet the criteria outlined in the DSM-5.
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What Is The Treatment For Schizophrenia
Schizophrenia is treated with medications combined with counseling and support.
Antipsychotics are the primary type of medication used to treat schizophrenia, and patients usually have to take these drugs for the rest of their lives. Antipsychotics often cause uncomfortable side effects and as a result, many patients stop taking them.
Never stop taking a prescribed medication without first talking to your doctor. It may be possible to change the dosage or regimen, or switch to a different medication to find one that works best for you and also minimize side effects. It often takes several attempts with different medications to find the right one for each individual patient.
Counseling and other support for schizophrenia include:
- Cognitive behavioral therapy
- Cognitive remediation interventions to help address the negative and cognitive symptoms of schizophrenia
- Supported employment
- Behavioral skills training
- Family education and support programs
- Coordinated specialty care , which is recovery-oriented treatment programs for people with first episode psychosis, an early stage of schizophrenia
- Assertive Community Treatment for individuals with schizophrenia who are at risk for repeated hospitalizations or homelessness
Unlabeled And Investigational Usage
The faculty of this educational activity may include discussions of products or devices that are not currently labeled for use by the FDA. Faculty members have been advised to disclose to the audience any reference to an unlabeled or investigational use.
No endorsement of unapproved products or uses is made or implied by coverage of these products or uses.
Please refer to the official prescribing information for each product for discussion of approved indicators, contraindications and warnings.
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Myths About Schizophrenia Symptoms
One common misconception is that violence or aggression are common symptoms of the condition. It is important to recognize that this is not the case. Having schizophrenia does not mean that a person is violent or dangerous. While the condition is chronic, it can be managed effectively with medications, therapy, and support.
Treatment For Negative Symptoms
Treating negative symptoms is tricky due to the very nature of the negative symptoms someone experiencing a lack of motivation, enthusiasm, or desire to be social, for instance, may be hesitant to seek and stick with treatment.
In addition, the drugs used to treat positive symptoms of schizophrenia can increase secondary negative symptoms and do not work on primary and persistent negative symptoms. This is why effective treatment ideally includes a combination of drugs, therapy, and support.
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Types Of Negative Symptoms
The first step in managing the negative symptoms of schizophrenia is to understand the different types, which typically have one of four defining features:
- Affective deficits:lack of facial expression, eye contact, gestures, and variations in voice pattern
- Avolition deficits: severe lack of motivation or initiative to accomplish purposeful tasks
- Communicative deficits:speech lacking in quantity or information
- Relational deficits:lack of interest in social activities and relationships
Because negative symptoms can include deficits in cognitive, emotional, and social abilities, there can be a large number of potential symptoms. The most recent version of the Diagnostic and Statistical Manual of Mental Disorders describes negative symptoms as restricted emotional expression and avolition, and includes the following five types.