Delusions:
A delusion is defined as a "personal belief based on an incorrect inference of external reality."2 A person who is delusional may be extremely paranoid, may think that he/she is involved in some complex scheme, or may think that he/she is a god. Delusions occur when the brain cannot properly process what a person is actually experiencing, thus leading the person to form misconceptions about what is happening, or what could happen, in his/her life.
Hallucinations:
Hallucinations can take on many different forms. In general a hallucination is a false perception that has not truly happened, but that the person actually experiences as being real. Auditory hallucinations generally take the form of the person hearing voices and can even involve multiple voices talking about the person experiencing the hallucination. Command auditory hallucinations are when voices tell a person to do something that would bring about harm to his/herself or to others. Visual hallucinations can take many forms from just flashing lights to complex scenes that may be enjoyable or may be extremely terrifying. Olfactory and gustatory hallucinations are when a person either tastes or smells something that is not really there. These are not common with schizophrenia and normally indicate the person has a brain tumor or has had a stroke. Tactile hallucinations are pain or discomfort perceived by a person without any external stimuli causing the sensation. Cenesthetic hallucinations are when someone claims to actually feel bodily functions like blood pumping through the body or urine forming . Finally, kinesthetic hallucinations cause a person to feel like his/her body is moving when in reality it is not.
Disorganized Speech:
People with schizophrenia who are actively experiencing psychotic symptoms will have difficulty forming coherent thoughts and difficulty speaking. They may be speaking what to us seems like nonsense, they may be speaking very quickly and in a pressured way, and they may make loose associations causing them to change the conversation rapidly and often.
Grossly Disorganized or Catatonic Behavior:
A person may begin to lose his/her ability to do activities that he/she was able to do before. This maladaptive behavior can include a decline in the person's personal relationships and/or job performance and a deterioration in personal appearance and the loss of ability to perform daily hygiene, which is usually the first observable symptom and a warning sign to family and friends. Catatonia is "a stuporous state in which the patient may require complete physical nursing care, similar to that for a comatose patient, sometimes with unpredictable outbursts of aggressive behavior or strange posturing."2
Negative Symptoms:
Negative symptoms refers to any symptoms of diminished normal behaviors. An example of a negative symptom is having a flat affect. This means the person is not showing any signs of emotions. However, it does not mean the person is not experiencing any emotions, he/she is just unable to express any emotions. Other negative symptoms include apathy, without any interest or concern, and anhedonia, a decreased ability to experience joy or pleasure.
The following video is a great summary of what I have discussed here and in the last post on diagnosing schizophrenia.
3
References:
1: Tandon, R., Gaebel, W., Barch, D. M., Bustillo, J., Gur, R. E., Heckers, S., & ... Carpenter, W. (2013). Definition and description of schizophrenia in the DSM-5. Schizophrenia Research, 150(1), 3-10. doi:10.1016/j.schres.2013.05.028
2: Stuart, G. (2013). Chapter 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders. In Principles and practice of psychiatric nursing (10th ed., pp. 344-375). Maryland Heights, Mo.: Elsevier Saunders.
3: Howcast. (2013, August 19). Symptoms & Criteria for Diagnosis | Schizophrenia [Video file]. Retrieved from https://www.youtube.com/watch?v=MfFQvKQUFiY
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