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Symptoms & Signs of Schizophrenia

Schizophrenia is an extremely serious mental health disorder that alters the thought processes, emotions and behaviors of affected individuals. Most people probably associate the condition with one of its classic symptoms, psychosis. However, psychosis is just one of the problems that can occur in people dealing with schizophrenia. In fact, the disorder can trigger three broad categories of symptoms, known as “positive” symptoms, “negative” symptoms and cognitive symptoms.

Positive Schizophrenia Symptoms

It seems strange to call any symptoms of schizophrenia “positive.” However, this medical term simply means that the problems in this category don’t normally appear in people in good mental health. All indications of psychosis of psychosis fall within this category.

Hallucinations — Hallucinations are experiences that seem to come from one of the five senses, but in fact do not. Instead, the stem from changes in brain chemistry and brain function. People with schizophrenia tend to have auditory hallucinations that manifest as second-person or third-person voices. However, they may also have visual, olfactory (smell-related) or tactile (touch-related) hallucinations, as well as auditory hallucinations that manifest as sounds.

Delusions — A delusion is a demonstrably false belief that an individual nevertheless strongly views as true or accurate. In many cases, this type of belief features irrational or bizarre thought processes that only make sense to the affected person. People with schizophrenia tend to have paranoid delusions that center on themes of persecution or external control. However, they may also develop a broad range of other delusional beliefs.

Disorganized Thinking/Speech — Even when they’re not affected by delusions, people with schizophrenia can experience unusual leaps or gaps in their thought processes. This makes it difficult to keep thoughts functional and well-organized. Disorganized thinking typically leads to disorganized patterns of speech.

Unusual Motor Behavior — The term unusual motor behavior refers to a range of unpredictable or age-inappropriate physical behaviors that have no clear goal. Common examples include unusual body postures, aimless movement and a total lack of body responsiveness (catatonia).

Negative Schizophrenia Symptoms

Schizophrenia in women and men can also lead to an absence of certain typical behaviors and emotions. Doctors refer to symptoms that indicate this absence as “negative” symptoms.

Emotional Flatness — Symptoms in this category point to a reduced ability to express emotion. They include a lack of vocal or physical emphasis when speaking and a lack of changing facial expressions.

Anhedonia — Anhedonia is a term that doctors use to describe a reduced or lost ability to feel pleasure, even when engaging in previously favored activities.

Disrupted Patterns of Activity — People with schizophrenia often lose the ability to start participation in new activities. Affected individuals may also lose the ability to complete activities they’ve already started.

Reduced Participation in Speech — Affected individuals may significantly reduce their spoken interactions with others.

Cognitive Schizophrenia Symptoms

Cognition is a scientific term for the process of thinking, gaining knowledge and gaining understanding. Schizophrenia can produce disruptions in this process that range from relatively minor to severe.

Diminished Executive Function — Executive function is the common name for a group of crucially important, higher-level mental skills, including the ability to control impulsive behavior and the ability to make sound logical judgments. In affected individuals, these skills can decline significantly over time.

Disruptions in Working Memory — Working memory is a form of short-term memory that all people rely on to remember things long enough to use them for immediate purposes. People with schizophrenia often experience problems with this form of memory, and thereby lose some of their normal orientation to reality.

Attention Difficulties — Schizophrenia can trigger a decline in the ability to focus or maintain attention.

When Do Doctors Diagnose the Condition?

When assessing you or your loved one for schizophrenia, doctors focus their attention on positive and negative symptoms rather than cognitive symptoms. An official diagnosis requires the presence of at least two of the following five problems: hallucinations, delusions, disorganized thinking/speech, unusual motor behavior and any one of the four negative symptoms. In addition, these problems must persist for at least six months and cause a serious impact for at least one month.


National Institute of Mental Health: Schizophrenia

National Alliance on Mental Illness: Schizophrenia

U.S. National Library of Medicine – MedlinePlus: Schizophrenia

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