Malcolm Rivera
Schizophrenia is a mental illness that impacts how someone thinks, feels, and behaves. The symptoms of schizophrenia can be classified as positive, negative, or cognitive. Positive symptoms are symptoms that are present in a person with schizophrenia but are not normally present in healthy individuals. They include hallucinations, delusions, and repetitive movements that are hard to control. Negative symptoms are characterized by the loss of important cognitive or behavioral functions, such as the inability to show emotions, apathy, and withdrawing from social situations. These symptoms are not specific to schizophrenia and can be seen in other mental illnesses such as bipolar disorder.
| Characteristics | Values |
|---|---|
| Positive symptoms | Hallucinations, delusions, repetitive movements that are hard to control |
| Negative symptoms | Inability to show emotions, apathy, difficulties talking, withdrawing from social situations and relationships |
| Cognitive symptoms | Disorganized thoughts, memory problems, difficulties with focus and attention |
| Treatments | Cognitive behavioral therapy (CBT), social skills training, antipsychotics |
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What You'll Learn
- Positive symptoms include hallucinations, delusions, and repetitive movements
- Negative symptoms include the inability to show emotions, apathy, and difficulties talking
- Cognitive symptoms include disorganized thoughts, memory problems, and attention issues
- Positive symptoms are present but shouldn't be, like faulty reality interpretation
- Negative symptoms are absent or missing, like a loss of cognitive or behavioural function
Positive symptoms include hallucinations, delusions, and repetitive movements
Positive symptoms are defined as the presence of a behavioural function that is not normally present in an individual. They can be managed in many patients with currently available treatments. They include hallucinations, delusions, and repetitive movements.
Hallucinations are faulty interpretations of reality due to incorrect sensory perceptions. People with schizophrenia might hear, see, smell, or feel things no one else does. Auditory hallucinations are the most common, where a person hears voices in their head that may be angry or urgent and demand that they do things. Visual hallucinations are also common, where someone might see lights, objects, people, or patterns. They may also have trouble with depth perception and distance. Hallucinations can also affect the other senses, such as smell and touch.
Delusions are faulty interpretations of reality due to incorrect thoughts. Somatic delusions centre on the body, such as the belief that one has a terrible illness or bizarre health problem. Erotomanic delusions are romantic in nature, such as the belief that a celebrity is in love with them. Religious delusions involve a person's relationship with a deity, such as believing they are possessed by a demon. Grandiose delusions involve exaggerated beliefs about oneself, such as believing one is a major figure on the world stage.
Repetitive movements are hard-to-control movements that are often seen in people with positive symptoms. These can include any type of repetitive behaviour, such as pacing, rocking, or tapping.
Positive symptoms represent an exaggeration or distortion of a normal function. They are highly exaggerated ideas, perceptions, or actions that show the person can’t tell what’s real from what isn’t. They are important, relatively independent components of schizophrenia. They can be measured using the Positive and Negative Syndrome Scale (PANSS), which has been largely used to assess schizophrenia symptom intensity.
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Negative symptoms include the inability to show emotions, apathy, and difficulties talking
Negative symptoms refer to the absence or lack of normal mental functions involving thinking, behaviour, and perception. They are characterised by the loss of an important cognitive or behavioural function. These symptoms are intrinsic to the underlying pathophysiology of schizophrenia or related disorders. Negative symptoms can also be secondary symptoms that are related to psychiatric or medical comorbidities, adverse effects of treatment, or environmental factors.
People with negative symptoms may also experience apathy or anhedonia, meaning they may not seem to enjoy anything anymore and may lack interest in activities and social interactions. They may also experience avolition, which is a reduction in the motivation to pursue goals or complete tasks. This can manifest as a lack of energy or initiative and may be accompanied by feelings of apathy or indifference.
The severity of negative symptoms can be assessed using the Positive and Negative Syndrome Scale (PANSS), which has been widely used in research and clinical settings. However, it is important to note that negative symptoms have a higher burden of illness compared to positive symptoms due to the limited number of effective and evidence-based treatment options. Interventions aimed at addressing attitudes, behaviours, and poor psychosocial functioning may be beneficial, and skill-based interventions such as social skills training and cognitive remediation therapy have shown some promise in improving negative symptoms.
Negative symptoms can significantly impact a person's life and may indicate a more serious course of illness. They can affect a person's ability to socialise, take care of their basic needs, and interact with others. It is crucial to recognise and address these symptoms to reduce the burden on patients, caregivers, and healthcare systems.
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Cognitive symptoms include disorganized thoughts, memory problems, and attention issues
Schizophrenia symptoms are often classified into positive and negative symptoms, with a third group of symptoms known as cognitive symptoms. While positive symptoms refer to the presence of abnormal behaviours or cognitions, negative symptoms refer to the absence or lack of normal mental functions.
Cognitive symptoms include disorganized thoughts, memory issues, and attention problems. Disorganized thoughts can manifest as confused thoughts and disorganized speech, where the person may seem distracted or like they are zoning out. They may have trouble following conversations. Memory problems can cause issues with recalling information, and attention issues can lead to difficulties in focusing. These cognitive symptoms can impact an individual's ability to process and use information effectively.
The Positive and Negative Syndrome Scale (PANSS) is commonly used to assess the intensity of these symptoms in individuals with schizophrenia. This scale evaluates three main dimensions: positive symptoms, negative symptoms, and general psychopathology. While positive symptoms include hallucinations, delusions, and repetitive movements, negative symptoms encompass emotional withdrawal, apathy, and difficulties with speech and social interactions.
It is important to distinguish between primary and secondary negative symptoms. Primary negative symptoms are intrinsic to the underlying pathophysiology of schizophrenia, while secondary negative symptoms are related to other factors, such as psychiatric comorbidities or treatment side effects. Negative symptoms often carry a higher burden of illness due to limited effective treatment options and underrecognition.
Cognitive behavioural therapy (CBT) is a widely studied psychological intervention for negative symptoms. It helps individuals understand the link between their thoughts, behaviours, and feelings, aiming to bring about positive change. Additionally, general behavioural interventions, such as promoting a healthy lifestyle with exercise, adequate sleep, a healthy diet, and social participation, are recommended as part of the treatment course.
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Positive symptoms are present but shouldn't be, like faulty reality interpretation
Positive and negative symptoms are concepts used to understand severe mental illnesses, particularly schizophrenia. Positive symptoms refer to behaviours or cognitions that are present but should not be, such as faulty reality interpretation due to incorrect sensory perceptions (hallucinations) or thoughts (delusions). These symptoms are highly exaggerated ideas, perceptions, or actions that indicate the person cannot differentiate between what is real and what is not. For example, a person with schizophrenia might experience auditory hallucinations, hearing voices in their head that might be angry or urgent and demand that they do things. Visual hallucinations are also common, where someone might see lights, objects, people, or patterns, often of loved ones or friends who are no longer alive. These hallucinations can lead to a distorted interpretation of reality, such as trouble with depth perception and distance.
Delusions are another form of positive symptoms, where individuals hold strongly to beliefs that are not based on reality. Somatic delusions centre on the body, such as believing they have worms under their skin. Erotomanic delusions involve a person being convinced that someone they are not attracted to is pursuing them or that a celebrity is in love with them. Religious delusions can lead to the belief that they have a special relationship with a deity or that they are possessed by a supernatural entity. Grandiose delusions can make individuals consider themselves major figures on the world stage, such as politicians or entertainers. These delusions and hallucinations are positive symptoms as they add to the person's experience, distorting their interpretation of reality.
Positive symptoms also include repetitive movements that are challenging to control, indicating an exaggeration of normal bodily functions. These symptoms are often treated with dopamine D2 partial agonists and antagonists, and the severity is assessed using scales like the Positive and Negative Syndrome Scale (PANSS). However, there is limited information on how effective these treatments are in clinical trials.
Negative symptoms, on the other hand, refer to the absence or lack of normal mental functions involving thinking, behaviour, and perception. These symptoms include an inability to show emotions, apathy, difficulties with speech, and withdrawing from social situations and relationships. An individual with negative symptoms might exhibit a lack of pleasure, known as anhedonia, where they no longer seem to enjoy activities. Their speech might be restricted, and they may struggle to express their feelings, a condition called alogia. Negative symptoms can also lead to affective flattening, where the person's voice and facial expressions show little to no emotion, even in response to conversations or events around them. Social withdrawal is another common negative symptom, where individuals may stop making plans with friends or become hermits, exhibiting a reduced interest in social interactions. These symptoms indicate a loss of important cognitive or behavioural functions, in contrast to the exaggeration or addition of functions seen in positive symptoms.
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Negative symptoms are absent or missing, like a loss of cognitive or behavioural function
Negative symptoms refer to an absence or loss of normal mental functions involving thinking, behaviour, and perception. These symptoms can be primary or secondary. Primary symptoms are intrinsic to the underlying pathophysiology of schizophrenia, while secondary symptoms are related to psychiatric or medical comorbidities, adverse effects of treatment, or environmental factors.
People experiencing negative symptoms may exhibit a lack of pleasure, a condition known as anhedonia. They may also struggle with speech, not talking much or showing any feelings, a condition known as alogia. Their voices may sound flat, and they may not smile or show facial emotions during conversations or in response to their surroundings. This is known as affective flattening.
Negative symptoms can also lead to social withdrawal, where individuals may stop making plans with friends or become hermits. They may also struggle with abstract thinking and have difficulty processing and using information. These symptoms can be managed through interventions such as social skills training and cognitive remediation therapy, with cognitive behavioural therapy being the most widely studied intervention.
The absence of typical behaviours, such as bathing, taking care of basic needs, or showing emotions, can also be indicative of negative symptoms. These symptoms are considered more severe and carry a higher burden of illness due to the limited number of effective and evidence-based treatment options. Therefore, it is crucial to address negative symptoms to reduce the associated burden on patients, caregivers, and healthcare systems.
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Frequently asked questions
Positive symptoms refer to what is added to an individual's experience due to a disease. They are the presence of symptoms that should not be there. These include hallucinations, delusions, and repetitive movements that are hard to control.
Negative symptoms refer to things that an individual has lost or are missing due to a disease. They are the absence of typical behaviours or emotions. Negative symptoms include the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations.
Negative symptoms in schizophrenia include primary symptoms, which are intrinsic to the underlying pathophysiology of the disorder, and secondary symptoms related to other factors. Examples of negative symptoms include reduced motivation, interest in activities, social interactions, and the ability to experience pleasure. These symptoms can be managed with interventions targeting attitudes, behaviours, and psychosocial functioning, as well as existing treatments.
