Schizophrenia

Schizophrenia

Schizophrenia is characterized by a very complex and diverse appearance. A distinction is made between the acute and the chronic phase of the disease. In acute schizophrenia,  the focus is on phenomena that are not present in healthy people. Hearing voices and the persecution of persecution are examples of these so-called positive symptoms. At this stage, the patients refuse to be assigned any illness. During the chronic phase, the limitation of certain psychological functions and emotionality, which healthy people possess in full, prevails. These so-called negative or "minus" symptoms (i.e. something is missing) include characterized by social withdrawal, diminishing (leisure) interests, impoverishment of speech, lack of feelings, drive disorders and neglect of the exterior.

The following signs of illness can occur in the context of schizophrenia:

I disorder:

In the case of an I disorder, the boundary between the environment and the “I” blurs. Affected people experience themselves and their environment as unreal and strange. One's own actions can no longer be experienced as a unity of the person and the distinction between oneself and others is disturbed. For example, sufferers believe that outsiders can read, influence or even “take away” their thoughts. Some patients report that they feel manipulated, remotely controlled or hypnotized from the outside.

Disorders of emotional impulses (impaired affectivity):

The mood is often characterized by fluctuations, e.g. through the simultaneous or immediately changing occurrence of extreme moods and feelings. In connection with acute episodes and delirium experiences, there is often severe fear or depressed mood. With chronic illness there is often "flattening of the affect", i.e. the emotional state is indifferent, those affected feel empty inside. The facial expression is rigid, gestures and facial expressions impoverished, eye contact is avoided. The impaired affectivity is also expressed in social withdrawal, the person concerned appears to be of little interest, joyless and unable to sense closeness. Accompanying depressive episodes appear relatively often. In a high mood, silliness, lack of distance and ruthless disinhibition can prevail. Often the emotional expression and the current situation do not match in schizophrenic patients (e.g. being amused by terrible events). One speaks here of parathymia. At the behavioral level, i.e. Facial expressions / gestures and mood do not go together, this discrepancy is called paramimia.

Cognitive disorders

Cognitive impairments - in the areas of attention, concentration and memory - are a central component of the clinical picture of schizophrenia and often affect the majority of those affected in a strong and disabling form.

Thinking and speech disorders

Thinking appears torn, incoherent and without inner logic. Because of this, the linguistic utterances are becoming increasingly bizarre, words are jumbled up, the sentence structure is destroyed, new word formations (neologisms) are invented. Flow of thought and speech can be accelerated or slowed down. Sometimes the patients talk wrong, i.e. their statements do not fit the topic or their thoughts suddenly "tear off", so that they "lose the thread" in the conversation.

Delusion:

In the case of delusion, the person concerned develops pathological misconceptions that deviate from reality. For him, the delusions are so real that he stubbornly holds on to them, does not check them against reality and cannot be corrected by others. Almost all living conditions can be the subject of a delusion. The victim feels persecuted (delusion of persecution) or is impaired in another serious way (e.g. delusion of poisoning), seriously ill (hypochondriacal delusion) or is called to a major task in religious or political terms (megalomania). Individual delusions are not always easy to distinguish from reality. Delusion describes the mood before a delusion, in which the patient has the certainty that something is happening that affects him directly. Delusional perception is the incorrect assignment of the meaning of processes in the area, whereby everyday processes are often experienced as a signal or test.

Hallucinations:

Hallucinations are disturbances of perception in which the person perceives things without actually being there. These disorders can involve all the senses - in schizophrenia there are primarily acoustic hallucinations, less frequent touch hallucinations and only rarely optical hallucinations. Acoustic hallucinations are mostly voices that are heard without anyone speaking. If the voices are experienced as perceiving one's own thinking, one speaks of being voiced. There are also "dialogical voices", i.e. the person concerned thinks that he is listening to conversations about himself. "Commenting voices", e.g. can come from one part of the body describe all the patient's actions. “Imperative (requesting) voices” give the person concerned instructions to act.

Abnormalities in psychomotricity (catatonic symptoms):

There is a reduction in drive in terms of activity, spontaneity and initiative. The emotional responsiveness and the spontaneous ability to turn and communicate decrease. With full consciousness, the patient can be completely motionless and unresponsive (stupor). On the other hand, if there is a strong motor excitement, this can manifest itself in stereotypical movements or even aimless aggressiveness. When dealing with schizophrenics, it can happen that everything is spoken or reproduced, the opposite is automatically carried out or in general what is ordered (stereotypes).

Depending on the prevalence of certain symptoms, a distinction can be made between subtypes that can merge with one another during the course of the disease. The subtypes (e.g. paranoid, raised or catatonic schizophrenia) do not form their own disease units, but only describe the individual combination and expression of the symptoms.

Affected people often have other mental illnesses such as depression or addiction. Many young patients with schizophrenia consume cannabis (new scientific evidence suggests that cannabis can trigger schizophrenia or accelerate the onset of the disease if there is an inherited burden). Some patients also experience physical complaints such as constipation or diarrhea, rapid heartbeat and impaired mental performance.

Also read: Bipolar Disorder