What are the common symptoms of schizophrenia?

  Schizophrenia is a group of common severe psychiatric disorders of unknown etiology, mostly with a slow or subacute onset in young adults, often manifesting clinically as psychiatric syndromes with varying symptoms involving multiple impairments in perception, thinking, emotion and behavior, as well as incoordination of mental activities.  Most patients do not recognize their illness, are reluctant to seek medical attention, have no self-awareness, are generally conscious, and have basically normal intelligence, but some patients may develop cognitive impairment during the course of the disease. The course of the disease is generally prolonged, with recurrent episodes, exacerbation or deterioration, and some patients eventually experience decline and mental disability, but some patients can remain cured or basically cured after treatment.  The clinical symptoms of schizophrenia are very complex and diverse, and the clinical manifestations can vary greatly among different types and stages of patients. However, it has characteristic thinking and perceptual disorders, emotional and behavioral incoherence and detachment from the real environment, which are now described as follows: 1. Thought association disorder: The thought association process lacks coherence and logic, and the disease has characteristic disorders. The characteristics of the patient in the case of consciousness, thinking associations scattered or split, lack of specificity and realism. In conversation, the patient may give irrelevant answers to questions and give irrelevant descriptions of things, making it difficult for people to understand, which is called “lax thinking”. In severe cases, the speech is fragmented, i.e. “fractured thinking”, and even individual statements lack connection with each other, called “word jumble”. Sometimes the patient can suddenly interrupt his thinking without any external influence, i.e., interrupted thinking, or a large number of thoughts with a clear sense of involuntary, called compulsive thinking. Some patients use some very ordinary words or actions, to express some special, other than the patient’s own incomprehensible meaning, called pathological symbolic thinking, or two or several completely unrelated words put together to give special meaning, called the word new work.  2. Affective disorders: Emotional retardation and indifference, incompatibility of emotional reactions with the content of thought as well as external stimuli, are important features of schizophrenia. The earliest involves more delicate emotions, such as lack of concern and sympathy for comrades and lack of consideration for relatives. Later, the patient becomes emotionally unresponsive to things around him or her and less interested in life and learning. As the disease progresses, the patient’s emotions become increasingly indifferent, even to things that cause great pain, but also shows a surprisingly flat, and finally the patient can lose any emotional connection with the surrounding environment. Along with the emotional indifference, there can be a dissonance between the emotional response and the environment, and a mismatch with the content of thought. Patients may become furious over trivial matters, or laughingly recount their misfortunes, the latter being called emotional inversion.  3. Voluntary activity disorder: The patient’s activity decreases, lacks initiative, and his behavior becomes withdrawn, passive, and retreating, i.e., his volitional activity decreases. The patient’s demand for life, study and labor is reduced, manifested by not actively interacting with others, unexplained absenteeism from school or work, etc.. In severe cases, the behavior is extremely passive, and so are the basic requirements of life. Patients do not pay attention to hygiene, do not bathe for a long time, do not comb their hair, live a lazy life, do nothing all day long, sit or lie in bed. Some patients’ behavior is completely incompatible with the environment, eating something inedible (such as soap, sewage), hurting their own bodies, etc., called intention inversion. Or dominated by hallucinations and bizarre thoughts.  4, hallucinations and sensory perception syndrome: hallucinations are seen in more than half of the patients, and sometimes can be quite persistent. The most common is hallucinations, mainly verbal hallucinations. They are divided into commentary hallucinations, command hallucinations, and thought chirps. Phantom smell, phantom touch, and phantom taste are less common. Perceptual syndromes are not uncommon in schizophrenia. Personality dissociation has certain characteristics in schizophrenia, such as the patient feels that the head has left his or her body, loses weight, the body is so light that it seems to be able to blow up, and does not feel the presence of the lower limbs when walking.  5. Primary delusions: Primary delusions do not occur very frequently in this disease, but they are diagnostically important and a characteristic symptom of this disease. These delusions occur suddenly and cannot be explained by the patient’s situation and psychological background at that time. For example, when a patient returns from abroad, he suddenly feels that his environment has changed as soon as he gets off the train, and he sees that the attitudes of people around him have changed, and they are all paying attention to him, and pedestrians are looking at him in a special way, and the attitudes of his family members are different from usual, and the conversations are talking about things related to him, etc. Secondary delusions often occur on top of hallucinations.  6. Catatonia syndrome: The most obvious manifestation of this syndrome is catatonic rigidity, in which the patient is silent, defiant, or passively submissive, and is accompanied by increased muscle tone.  Patients with schizophrenia generally have no impairment of consciousness, and delusions, hallucinations, and other thought disorders are generally found in the presence of consciousness. In the early stages of the disease, there is no intellectual impairment, and the patient’s self-awareness is mostly lacking – the majority of patients do not admit that they are ill and refuse to seek medical care and medication, which requires early detection by family members and timely transportation to a hospital or psychiatric specialist.