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| Boilerpipe Text | Schizophrenia
Overview
Hallucinations
Medically Reviewed
Schizophrenia Symptoms & Diagnosis
By
(Image: iStock)
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Jump To
What Is Schizophrenia?
Symptoms
Diagnosis
Schizophrenia is a chronic psychological disorder that affects a personâs thoughts, feelings, and behavior. A person suffering from schizophrenia has difficulty distinguishing between what is real and what is not real. Major symptoms that include delusions and hallucinations are distressing and make it difficult for one to carry out day-to-day activities and maintain relationships.
The illness is diagnosed in about 1.1 percent of the population.š Onset is around age 16 to 30, although onset for males is typically earlier than females.²
Symptoms of
schizophrenia
are categorized as âpositiveâ or ânegative.â A positive symptom, such as delusions or hallucinations, adds a feeling or behavior that isnât typically experienced by most people without schizophrenia. A negative symptom takes away a feeling or ability that is normally present in most people, but is now missingâsuch as a lack of motivation. Most people with schizophrenia experience both positive and negative symptoms.
The experience of positive symptoms in schizophrenia designates a break with reality and is referred to as psychosis.Âł Patients can experience either hallucinations or delusions, or both simultaneously.
Hallucinations are the experience of visual, auditory, or olfactory sensations that others cannot see, hear, or smell. Auditory hallucinations can include hearing a voice or voices in oneâs head, which the person does not identify as their own internal voice or thoughts. These voices can be disparaging and threatening.â´
Delusions are firmly held irrational beliefs that the patient upholds despite evidence to the contrary. Common forms of delusions in schizophrenia include:
Delusions of persecution.
This is a strongly held belief that someone or something means to do you physical or emotional harm. An example of a delusion of persecution is believing that your next-door neighbor is entering your home while you are sleeping in order to poison your food or to spy on you.
Delusions of grandeur.
This is a belief that you are an important, powerful, or famous person. That could mean that you are royalty, a historical figure, or even a deity. You may believe you also have special powers, such as an ability to know the future.
Delusions of reference.
You feel that something or someone is referring to you when it is not. These delusions can take on many forms. For instance, you may believe something you read in the newspaper refers to you or your thoughts. An actor talking in a movie may seem like theyâre sending a message to you personally. Neutral or innocuous stimuli seem to take on personal and possibly harmful significance.
Thought insertion.
This is the belief that your thoughts are not your own, rather they were placed there by an outside source. This is similar to auditory hallucinations; someone with schizophrenia can attribute internal stimuliâlike their thoughtsâas coming from an external source.
Thought broadcasting.
One may feel as though their thoughts are not being privately contained inside their own mind. Instead their thoughts are being broadcast so that someone or something can observe or collect them. This could be literal
broadcasting
, such as the belief that aliens are projecting your thoughts into outer space via radio waves. It could also mean a general feeling that people around you know your thoughts without you having to speak or share them.
A psychotic person is not aware of the bizarre nature of his or her delusions or hallucinations. They cannot simply be âtalked outâ of these beliefs, or be made to shown how they are untrue. That's because their mental condition causes what's called anosognosia, which means a âlack of insightâ into a mental health condition.âľ It may seem plainly untrue to someone not suffering from schizophrenia that the mail carrier would be sending hidden messages to you via weekly circulars, but a person with schizophrenia cannot see why this is illogical.
Someone with schizophrenia may also experience disorganized speech, such as incoherence, perseveration (the repetition of words), frequent derailment (touching on unrelated or loosely associated ideas), or word salad (an unintelligible mixture of nonsense or made-up words). They may display grossly disorganized or catatonic behavior, including stupor or extreme rigidity or flexibility of the limbs.âś
Negative symptoms⡠of schizophrenia include:
Avolition.
Lack of motivation, inability to follow goal-oriented action.
Anhedonia.
Inability to experience pleasure.
Social withdrawal.
No interest in being with other people.
Difficulty paying attention.
Apathy.
This can show up as lack of personal hygiene or a lack of concern for others or self.
Affective flattening.
An absence of emotional expression facially, vocally, even a lack of body language.
Alogia.
Reduction in speech, little detail used when communicating.
Someone suffering from schizophrenia could experience any combination of positive or negative symptoms. Symptoms tend to persist or occur separately from those of a mood episode like severe
depression
or bipolar mania.
People with schizophrenia also often experience impaired executive function, including working memory. This means they may be unable to process, interpret, and retain new information or recall this information in order to perform a task later. Deficits in attention and short-term memory are common.â¸
A psychiatrist or psychologist can
diagnose schizophrenia
. There is no laboratory or medical test for schizophrenia. Instead, a mental health professional will evaluate the patient and rule out other physical and psychological conditions. Once diagnosed, a treatment plan including medication and psychotherapy is typical.âš
While proper administration of antipsychotic medication can eliminate positive symptoms of the illness, negative symptoms often persist and are harder to treat with medication.
Seeking help as soon as symptoms arise is particularly important. The earlier the intervention the more likely the patient is to make a socio-occupational recovery, possibly even reversing the effects of psychosis.šâ°
http://www.sardaa.org/resources/about-schizophrenia/
https://www.nimh.nih.gov/health/publications/schizophrenia-booklet/index.shtml#pub3
https://www.nimh.nih.gov/health/topics/schizophrenia/raise/what-is-psychosis.shtml
https://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia
http://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Anosognosia
http://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
https://www.livingwithschizophreniauk.org/advice-sheets/negative-symptoms-understanding/
https://www.livingwithschizophreniauk.org/cognitive-symptoms-schizophrenia/
https://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia
http://www.nami.org/earlypsychosis
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- [Schizophrenia](https://www.healthcentral.com/category/schizophrenia)
- [Overview](https://www.healthcentral.com/condition/schizophrenia)
- [Hallucinations](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-without-hallucinations)
Medically Reviewed
# Schizophrenia Symptoms & Diagnosis
Updated Jan 23, 2023
By
[Dina Cagliostro, Ph.D.](https://www.healthcentral.com/author/dina-cagliostro)
Medical Reviewer[Jean Kim, M.D., M.A.](https://www.healthcentral.com/author/jean-kim)

(Image: iStock) (Image: iStock)
###### Jump To
- [What Is Schizophrenia?](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-symptoms-diagnosis#what-is-schizophrenia)
- [Symptoms](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-symptoms-diagnosis#symptoms)
- [Diagnosis](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-symptoms-diagnosis#diagnosis)
## What Is Schizophrenia?
Schizophrenia is a chronic psychological disorder that affects a personâs thoughts, feelings, and behavior. A person suffering from schizophrenia has difficulty distinguishing between what is real and what is not real. Major symptoms that include delusions and hallucinations are distressing and make it difficult for one to carry out day-to-day activities and maintain relationships.
The illness is diagnosed in about 1.1 percent of the population.š Onset is around age 16 to 30, although onset for males is typically earlier than females.²
## Symptoms
Symptoms of [schizophrenia](https://www.healthcentral.com/condition/schizophrenia) are categorized as âpositiveâ or ânegative.â A positive symptom, such as delusions or hallucinations, adds a feeling or behavior that isnât typically experienced by most people without schizophrenia. A negative symptom takes away a feeling or ability that is normally present in most people, but is now missingâsuch as a lack of motivation. Most people with schizophrenia experience both positive and negative symptoms.
The experience of positive symptoms in schizophrenia designates a break with reality and is referred to as psychosis.Âł Patients can experience either hallucinations or delusions, or both simultaneously.
Hallucinations are the experience of visual, auditory, or olfactory sensations that others cannot see, hear, or smell. Auditory hallucinations can include hearing a voice or voices in oneâs head, which the person does not identify as their own internal voice or thoughts. These voices can be disparaging and threatening.â´
Delusions are firmly held irrational beliefs that the patient upholds despite evidence to the contrary. Common forms of delusions in schizophrenia include:
- **Delusions of persecution.** This is a strongly held belief that someone or something means to do you physical or emotional harm. An example of a delusion of persecution is believing that your next-door neighbor is entering your home while you are sleeping in order to poison your food or to spy on you.
- **Delusions of grandeur.** This is a belief that you are an important, powerful, or famous person. That could mean that you are royalty, a historical figure, or even a deity. You may believe you also have special powers, such as an ability to know the future.
- **Delusions of reference.** You feel that something or someone is referring to you when it is not. These delusions can take on many forms. For instance, you may believe something you read in the newspaper refers to you or your thoughts. An actor talking in a movie may seem like theyâre sending a message to you personally. Neutral or innocuous stimuli seem to take on personal and possibly harmful significance.
- **Thought insertion.** This is the belief that your thoughts are not your own, rather they were placed there by an outside source. This is similar to auditory hallucinations; someone with schizophrenia can attribute internal stimuliâlike their thoughtsâas coming from an external source.
- **Thought broadcasting.** One may feel as though their thoughts are not being privately contained inside their own mind. Instead their thoughts are being broadcast so that someone or something can observe or collect them. This could be literal *broadcasting*, such as the belief that aliens are projecting your thoughts into outer space via radio waves. It could also mean a general feeling that people around you know your thoughts without you having to speak or share them.
A psychotic person is not aware of the bizarre nature of his or her delusions or hallucinations. They cannot simply be âtalked outâ of these beliefs, or be made to shown how they are untrue. That's because their mental condition causes what's called anosognosia, which means a âlack of insightâ into a mental health condition.âľ It may seem plainly untrue to someone not suffering from schizophrenia that the mail carrier would be sending hidden messages to you via weekly circulars, but a person with schizophrenia cannot see why this is illogical.
Someone with schizophrenia may also experience disorganized speech, such as incoherence, perseveration (the repetition of words), frequent derailment (touching on unrelated or loosely associated ideas), or word salad (an unintelligible mixture of nonsense or made-up words). They may display grossly disorganized or catatonic behavior, including stupor or extreme rigidity or flexibility of the limbs.âś
Negative symptoms⡠of schizophrenia include:
- **Avolition.** Lack of motivation, inability to follow goal-oriented action.
- **Anhedonia.** Inability to experience pleasure.
- **Social withdrawal.** No interest in being with other people.
- **Difficulty paying attention.**
- **Apathy.** This can show up as lack of personal hygiene or a lack of concern for others or self.
- **Affective flattening.** An absence of emotional expression facially, vocally, even a lack of body language.
- **Alogia.** Reduction in speech, little detail used when communicating.
Someone suffering from schizophrenia could experience any combination of positive or negative symptoms. Symptoms tend to persist or occur separately from those of a mood episode like severe [depression](https://www.healthcentral.com/condition/depression) or bipolar mania.
People with schizophrenia also often experience impaired executive function, including working memory. This means they may be unable to process, interpret, and retain new information or recall this information in order to perform a task later. Deficits in attention and short-term memory are common.â¸
## Diagnosis
A psychiatrist or psychologist can [diagnose schizophrenia](https://pro.psycom.net/assessment-diagnosis-adherence/schizophrenia). There is no laboratory or medical test for schizophrenia. Instead, a mental health professional will evaluate the patient and rule out other physical and psychological conditions. Once diagnosed, a treatment plan including medication and psychotherapy is typical.âš
While proper administration of antipsychotic medication can eliminate positive symptoms of the illness, negative symptoms often persist and are harder to treat with medication.
Seeking help as soon as symptoms arise is particularly important. The earlier the intervention the more likely the patient is to make a socio-occupational recovery, possibly even reversing the effects of psychosis.šâ°
This article was originally published March 13, 2017 and most recently updated January 23, 2023.
Š 2026 HealthCentral LLC. All rights reserved.
Sources
1. http://www.sardaa.org/resources/about-schizophrenia/
2. https://www.nimh.nih.gov/health/publications/schizophrenia-booklet/index.shtml\#pub3
3. https://www.nimh.nih.gov/health/topics/schizophrenia/raise/what-is-psychosis.shtml
4. https://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia
5. http://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Anosognosia
6. http://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
7. https://www.livingwithschizophreniauk.org/advice-sheets/negative-symptoms-understanding/
8. https://www.livingwithschizophreniauk.org/cognitive-symptoms-schizophrenia/
9. https://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia
10. http://www.nami.org/earlypsychosis
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[Jean Kim, M.D., M.A., Clinical Psychiatrist:](https://www.healthcentral.com/author/jean-kim)
Jean Kim, M.D., M.A., currently works as a Medical Officer in the U.S. Department of Health and Human Services.

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Medically Reviewed
# Can Drug Use Trigger Psychosis?
Drug use cannot cause schizophrenia, but it can trigger and worsen existing schizophrenia symptoms such as psychosis.
Updated Jan 23, 2023
By
[Ilene Raymond Rush](https://www.healthcentral.com/author/ilene-r-rush)
Medical Reviewer[Michael McGee, M.D.](https://www.healthcentral.com/author/michael-mcgee)

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###### Jump To
- [Drug Use & Schizophrenia](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-symptoms-diagnosis#drug-use--schizophrenia)
- [Cannabis](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-symptoms-diagnosis#cannabis)
- [Symptoms and Diagnosis](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-symptoms-diagnosis#symptoms-and-diagnosis)
- [Treatment](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-symptoms-diagnosis#treatment)
Many drugs, from marijuana to methamphetamine to prescription medications, can provoke drug-induced psychosis. People with drug-induced psychosis experience a break from reality that can include hallucinationsâwhere they see, hear and sense things that arenât realâand delusions, where they believe things that arenât true.š
While these psychotic symptoms are shared by individuals with [schizophrenia](https://www.healthcentral.com/condition/schizophrenia), a thought disorder that affects a personâs ability to think, feel or behave clearly, important differences divide the two.
But given the similarity of their presentation, it can be tricky for clinicians to figure out the source of a psychotic break. Itâs made more difficult by the fact that people with schizophrenia often exhibit a high rate of [substance abuse](https://www.healthcentral.com/substance-abuse-and-addiction).
âIt can be challenging to distinguish drug-induced psychosis from other forms of psychosis,â says Michael Knable, DO, a psychiatrist who is the medical director of Clearview Communities LLC, chairman of the board for the Treatment Advocacy Center and member of the District of Columbia Commission on Mental Health. âThis is because many people with diagnoses of schizophrenia may also misuse drugs.â
Drug Use & Schizophrenia
## Can Drug Use Cause or Trigger Schizophrenia?
While drugs cannot cause schizophrenia, having a drug-induced psychosis can sometimes reveal an underlying mental illness. In certain cases, a drug-induced psychotic episode may precede a schizophrenia diagnosis.²
âThe vast majority of people who develop a psychosis from drug use will have a brief group of psychotic symptoms which will go away when the drug is out of their system and then they will be fine,â Dr. Knable says. âBut if you have chronic and persistent psychosis after taking drugs you probably were going to have a mental illness in the first place, and it just hadnât yet declared itself.â
Unlike schizophrenia, people with drug-induced psychosis generally recover within three to five days, when the drug no longer remains in their system. In some cases, if drug abuse has been more substantial, it may take longer. For example, sometimes recreational or high-dose [meth](https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00491/full) use can induce a permanent psychosis that is different from schizophrenia.
If symptoms linger, itâs vital to see a psychiatrist or neurologist who can assess a patient for mental health conditions, neurological disorders, and other diagnoses that may lead to psychosis.
âIf youâre 18 years old and you have a bad LSD trip and you have psychotic symptoms and they donât go away, people used to say that was because of the drug,â says Dr. Knable. âBut no oneâs actually proven that is true; it might have been an underlying mental health condition revealed by the drug.â
And for those with an underlying mental condition, drugs can make it worse.
âIf you have an underlying psychosis, drugsâincluding cocaine, cannabis, methamphetamine, PCP, LSD, and othersâare going to make your illness worse,â Dr. Knable explains. âAnd even more concerning, the medicines you take to treat your mental disease will not be as effective.â
Cannabis
## Cannabis and Schizophrenia
Cannabis can be particularly problematic for people with underlying mental health issues, because in genetically predisposed or at-risk groups, it can lead to an earlier diagnosis of psychosis and schizophrenia.
Studies have shown that cannabis can increase the risks of developing psychosis, particularly in subjects âalready at risk for psychiatric disturbances.â Cannabis has the highest conversion rate (47%) to schizophrenia compared to other substance-induced psychosis.ÂłËâ´
In addition, frequent cannabis use doubles the risk of developing schizophrenia at a younger age, and the earlier presentation of psychotic symptoms can worsen the long-term outcome.âľ
When a healthy person uses cannabis, she may experience relaxation, euphoria, and a decrease in [anxiety](https://www.healthcentral.com/condition/anxiety) and boredom. Undesirable effects can include paranoia, grandiosity, agitation, hallucination, cognitive impairment, disorganized thinking and behavior, and depersonalization.
Two factors contribute to this. One is the content of THC in the cannabis, with THC levels having a direct relation to psychotic symptoms. THC is the substance primarily responsible for the drugâs effect on a personâs mental state. The amount of THC in cannabisâwhich is often unknownâcan make the symptoms of schizophrenia and psychosis worsen and cause more relapses and hospitalizations.âś
Second, the conversion to schizophrenia seems associated with the duration of cannabis use. Researchers found that patients who completely abstained after their first episode of cannabis-induced psychosis had no relapse of psychiatric illness. However, among cannabis users who experienced their first psychotic break at a young age, 50%-100% continued using the drug.âľ
Reflecting these issues, Dr. Knable warns patients with schizophrenia to abstain from cannabis.
âPeople with schizophrenia should never smoke marijuana, because they are much more susceptible to the psychotic effects of marijuana if they have an underlying psychosis,â he said.
Symptoms and Diagnosis
## Symptoms and Diagnosis
While both schizophrenia and drug-induced psychosis feature psychotic symptoms like hallucinations and delusions, there are important distinctions.
In drug-induced psychosis, symptoms occur more suddenly and aggressively and appear only when an individual is either under the influence or in withdrawal from a drug.
While psychotic symptoms are more intense than in schizophrenia, they tend to disappear completely once the drug leaves a personâs system.
In comparison with schizophrenia, people must have psychotic symptoms that last over 6 months. Symptoms cannot be linked to drug use.
Symptoms of both conditions may include:
- Paranoia
- Hallucinations
- Delusions
- Dangerous behavior
- Disconnection from other people or from reality
Diagnosing a drug-induced psychosis from schizophrenia can be difficult. Doctors depend on taking a medical history, followed by a physical and mental exam and laboratory tests to determine medication and substance use.
Treatment
## Treatment for Drug-Induced Psychosis
Treatment for drug-induced psychosis first involves stopping the drug that caused the problem. Depending on the substance, a benzodiazepine or antipsychotic may be employed to stop symptoms of agitation. For stimulants like amphetamine, an antipsychotic may be best, while for others, such as LSD, providing a calm environment with observation may be enough.âˇ
âMost people will clear up within two or three days,â Dr. Knable says. âIf they come in saying they feel bugs crawling all over them and you give them antipsychotics they clear up.â
In cases where such psychotic symptoms remain, itâs vital to visit a psychiatrist or neurologist to assess a patient for mental health conditions, medical conditions, neurological disorders, or other factors that may have initiated psychosis.
Once psychotic symptoms have passed, patients with drug-induced psychosis who are drug dependent may enter a treatment program. Experts say a rehabilitative treatment approach is best; one that emphasizes other modalities including people, place, and purposeânot just medication and therapy. Doctors and pharmacists should be informed of the patientsâ history of drug induced psychosis to prevent the possibility of a second episode, particularly if the psychotic event was sparked by a prescription medication.
Among schizophrenia patients receiving treatment, substance misuse is associated with more severe symptoms and poorer therapeutic response. The presence of chronic psychosis impedes treatment of the substance problem in traditional, nonpsychiatric addiction programs.
Seeking treatment early for psychotic symptoms can help a person get the right care and reduce the risk that symptoms will negatively impact them.
Drug-Induced Psychosis FAQs
What is drug-induced psychosis?
Drug-induced psychosis occurs when a drugâranging from cannabis to methamphetamine to prescription medicationsâcauses a person to experience a break from reality that leads to hallucinations and delusional thinking.
Can you develop schizophrenia from drugs?
Drugs do not cause schizophrenia, but on occasion, a drug-induced psychosis can signal and unmask a serious underlying mental health disorder, such as schizophrenia. For that reason, if psychotic symptoms from a drug-induced psychosis remain after the effects of the drug have disappeared, itâs important to see a psychiatrist or neurologist for an evaluation.
How long can drug induced schizophrenia psychosis last?
Drug-induced psychosis typically only lasts until the drug has cleared from the body, generally from two to five days. Meth-induced psychoses are rarely permanent but symptoms may last a few years.
What are the differences between drug-induced psychosis and schizophrenia?
Schizophrenia can have several different causes, including a genetic predisposition to the disease, whereas drug-induced psychosis only occurs from drug use.
While both conditions share symptoms that include hallucinations, delusions, and disorganized thinking, in the case of drug-induced psychosis symptoms usually end after the drug has left a personâs system, while schizophrenia symptoms must last over six months and cannot be connected to drug use.
This article was originally published January 4, 2023 and most recently updated January 23, 2023.
Š 2026 HealthCentral LLC. All rights reserved.
Sources
1. Fiorentini A, CantĂš F, Crisanti C, Cereda G, Oldani L, Brambilla P. Substance-Induced Psychoses: An Updated Literature Review. Front Psychiatry. 2021 Dec 23; 12:694863. doi: 10.3389/fpsyt.2021.694863. PMID: 35002789; PMCID: PMC8732862. Available at <https://pubmed.ncbi.nlm.nih.gov/35002789/> Accessed January 4, 2023.
2. Paolo Fusar-Poli, Marco Cappucciati, Grazia Rutigliano, Margaret Heslin, Daniel Stahl, Zera Brittenden, Edgardo Caverzasi, Philip McGuire, William T. Carpenter, Diagnostic Stability of ICD/DSM First Episode Psychosis Diagnoses: Meta-analysis, *Schizophrenia Bulletin*, Volume 42, Issue 6, November 2016, Pages 1395â1406, [https://doi.org/10.1093/schbul/sbw020](https://academic.oup.com/schizophreniabulletin/article/42/6/1395/2399275)
3. Patel S, Khan S, M S, Hamid P. The Association Between Cannabis Use and Schizophrenia: Causative or Curative? A Systematic Review. *Cureus*. 2020 Jul 21;12(7): e9309. doi: 10.7759/cureus.9309. PMID: 32839678; PMCID: PMC7442038.
4. Shah D, Chand P, Bandawar M, Benegal V, Murthy P. Cannabis induced psychosis and subsequent psychiatric disorders. *Asian J Psychiatr*. (2017) 30:180â4. [https://doi.org/10.1016/j.ajp.2017.10.003](https://www.sciencedirect.com/science/article/abs/pii/S187620181730388X)
5. The potential of cannabidiol treatment for cannabis users with recent-onset psychosis. Hahn B. *Schizophr Bull*. 2018;44:46â53. [https://doi.org/10.1093/schbul/sbw020](https://academic.oup.com/schizophreniabulletin/article/42/6/1395/2399275)
6. Tandon, R. and Shariff, S.M., Substance-Induced Psychotic Disorders and Schizophrenia: Pathophysiological Insights and Clinical Implications 1 Sep 2019 [https://doi.org/10.1176/appi.ajp.2019.19070734](https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.19070734)
7. Merck. Merck Professional Version. Substance/Medication-Induced Psychotic Disorders. Updated April 2022. Modified September 2022. Available at <https://www.merckmanuals.com/professional/psychiatric-disorders/schizophrenia-and-related-disorders/substance-medication-induced-psychotic-disorder>. Accessed January 4, 2023.
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Ilene Raymond Rush is an award-winning health and science freelance writer. Based on her own experiences with type 2 diabetes, she brings a personal take and a reporterâs eye to examine the best and newest methods of treating and controlling the disease.
[Michael McGee, M.D., Psychiatrist:](https://www.healthcentral.com/author/michael-mcgee)
Michael McGee, M.D., is the President of WellMind, Inc. He treats patients in a forensic hospital and in his private practice. He also provides online wellness and personal growth services. He works and lives near San Luis Obispo, California.

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| Readable Markdown | - [Schizophrenia](https://www.healthcentral.com/category/schizophrenia)
- [Overview](https://www.healthcentral.com/condition/schizophrenia)
- [Hallucinations](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-without-hallucinations)
Medically Reviewed
## Schizophrenia Symptoms & Diagnosis
By

(Image: iStock) (Image: iStock)
###### Jump To
- [What Is Schizophrenia?](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-symptoms-diagnosis#what-is-schizophrenia)
- [Symptoms](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-symptoms-diagnosis#symptoms)
- [Diagnosis](https://www.healthcentral.com/condition/schizophrenia/schizophrenia-symptoms-diagnosis#diagnosis)
Schizophrenia is a chronic psychological disorder that affects a personâs thoughts, feelings, and behavior. A person suffering from schizophrenia has difficulty distinguishing between what is real and what is not real. Major symptoms that include delusions and hallucinations are distressing and make it difficult for one to carry out day-to-day activities and maintain relationships.
The illness is diagnosed in about 1.1 percent of the population.š Onset is around age 16 to 30, although onset for males is typically earlier than females.²
Symptoms of [schizophrenia](https://www.healthcentral.com/condition/schizophrenia) are categorized as âpositiveâ or ânegative.â A positive symptom, such as delusions or hallucinations, adds a feeling or behavior that isnât typically experienced by most people without schizophrenia. A negative symptom takes away a feeling or ability that is normally present in most people, but is now missingâsuch as a lack of motivation. Most people with schizophrenia experience both positive and negative symptoms.
The experience of positive symptoms in schizophrenia designates a break with reality and is referred to as psychosis.Âł Patients can experience either hallucinations or delusions, or both simultaneously.
Hallucinations are the experience of visual, auditory, or olfactory sensations that others cannot see, hear, or smell. Auditory hallucinations can include hearing a voice or voices in oneâs head, which the person does not identify as their own internal voice or thoughts. These voices can be disparaging and threatening.â´
Delusions are firmly held irrational beliefs that the patient upholds despite evidence to the contrary. Common forms of delusions in schizophrenia include:
- **Delusions of persecution.** This is a strongly held belief that someone or something means to do you physical or emotional harm. An example of a delusion of persecution is believing that your next-door neighbor is entering your home while you are sleeping in order to poison your food or to spy on you.
- **Delusions of grandeur.** This is a belief that you are an important, powerful, or famous person. That could mean that you are royalty, a historical figure, or even a deity. You may believe you also have special powers, such as an ability to know the future.
- **Delusions of reference.** You feel that something or someone is referring to you when it is not. These delusions can take on many forms. For instance, you may believe something you read in the newspaper refers to you or your thoughts. An actor talking in a movie may seem like theyâre sending a message to you personally. Neutral or innocuous stimuli seem to take on personal and possibly harmful significance.
- **Thought insertion.** This is the belief that your thoughts are not your own, rather they were placed there by an outside source. This is similar to auditory hallucinations; someone with schizophrenia can attribute internal stimuliâlike their thoughtsâas coming from an external source.
- **Thought broadcasting.** One may feel as though their thoughts are not being privately contained inside their own mind. Instead their thoughts are being broadcast so that someone or something can observe or collect them. This could be literal *broadcasting*, such as the belief that aliens are projecting your thoughts into outer space via radio waves. It could also mean a general feeling that people around you know your thoughts without you having to speak or share them.
A psychotic person is not aware of the bizarre nature of his or her delusions or hallucinations. They cannot simply be âtalked outâ of these beliefs, or be made to shown how they are untrue. That's because their mental condition causes what's called anosognosia, which means a âlack of insightâ into a mental health condition.âľ It may seem plainly untrue to someone not suffering from schizophrenia that the mail carrier would be sending hidden messages to you via weekly circulars, but a person with schizophrenia cannot see why this is illogical.
Someone with schizophrenia may also experience disorganized speech, such as incoherence, perseveration (the repetition of words), frequent derailment (touching on unrelated or loosely associated ideas), or word salad (an unintelligible mixture of nonsense or made-up words). They may display grossly disorganized or catatonic behavior, including stupor or extreme rigidity or flexibility of the limbs.âś
Negative symptoms⡠of schizophrenia include:
- **Avolition.** Lack of motivation, inability to follow goal-oriented action.
- **Anhedonia.** Inability to experience pleasure.
- **Social withdrawal.** No interest in being with other people.
- **Difficulty paying attention.**
- **Apathy.** This can show up as lack of personal hygiene or a lack of concern for others or self.
- **Affective flattening.** An absence of emotional expression facially, vocally, even a lack of body language.
- **Alogia.** Reduction in speech, little detail used when communicating.
Someone suffering from schizophrenia could experience any combination of positive or negative symptoms. Symptoms tend to persist or occur separately from those of a mood episode like severe [depression](https://www.healthcentral.com/condition/depression) or bipolar mania.
People with schizophrenia also often experience impaired executive function, including working memory. This means they may be unable to process, interpret, and retain new information or recall this information in order to perform a task later. Deficits in attention and short-term memory are common.â¸
A psychiatrist or psychologist can [diagnose schizophrenia](https://pro.psycom.net/assessment-diagnosis-adherence/schizophrenia). There is no laboratory or medical test for schizophrenia. Instead, a mental health professional will evaluate the patient and rule out other physical and psychological conditions. Once diagnosed, a treatment plan including medication and psychotherapy is typical.âš
While proper administration of antipsychotic medication can eliminate positive symptoms of the illness, negative symptoms often persist and are harder to treat with medication.
Seeking help as soon as symptoms arise is particularly important. The earlier the intervention the more likely the patient is to make a socio-occupational recovery, possibly even reversing the effects of psychosis.šâ°
1. http://www.sardaa.org/resources/about-schizophrenia/
2. https://www.nimh.nih.gov/health/publications/schizophrenia-booklet/index.shtml\#pub3
3. https://www.nimh.nih.gov/health/topics/schizophrenia/raise/what-is-psychosis.shtml
4. https://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia
5. http://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Anosognosia
6. http://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
7. https://www.livingwithschizophreniauk.org/advice-sheets/negative-symptoms-understanding/
8. https://www.livingwithschizophreniauk.org/cognitive-symptoms-schizophrenia/
9. https://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia
10. http://www.nami.org/earlypsychosis
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