While speaking in public, the patient changes topics frequently. This is a symptom of derailment. This is one of the positive symptoms of schizophrenia; is the descriptive term to a group of psychotic disorders in which personal, social and occupational functioning deteriorate as a result of disturbed thought processes, strong perceptions, unusual emotional states, and motor abnormalities. .
The social and psychological causes of schizophrenia are tremendous, both to patients as well as to their families and society.
Symptoms of schizophrenia:
• Positive Symptoms—comprise excesses and provide reduction of distress in the patient. It
comprises excesses of thought, emotion, and behaviour.
• Negative Symptoms—deficits of thought, emotion and behaviour.
• Psychomotor Symptoms.
Positive Symptoms of’Pathological Excesses :
1. Disorganized Thinking and Speech:
• People with schizophrenia may not be able to think logically, and may speak in peculiar ways.
• Formal thought disorders can make communication extremely difficult.
• It refers to problems in the organization of ideas and in speaking so that a listener can understand.
These include derailment, i.e., rapidly shifting from one topic to another so that the normal structure of thinking becomes illogical (loosening of association, derailed).
• Inventing new words, phrases, i.e., neologism and persistent and inappropriate repetition of the same thoughts.
2. Delusion: It is a false belief that is firmly held on inadequate grounds. It is not affected by emotional argument, and has no basis in reality.
• Delusion of Persecution: belief that they are being plotted against, spied on, slandered, threatened, attacked or deliberately victimized.
• Delusions of Reference: in which they attach special and personal meaning to the actions of
others or to objects and event. They believe that they can read others mind.
• Delusions of Grandeur: people believe themselves to be specially empowered with supernatural powers.
• Delusions of Control: they believe that their feelings, thoughts and actions are controlled by others.
3. Hallucinations: Perceptions that occur in the absence of external stimuli.
• Auditory hallucinations are most common in schizophrenia. Patients hear sounds or voices that speak words, phrases and sentences directly to the patients (second person hallucination) or talk to one another referring to the patient as he/she (third person hallucination).
• Tactile hallucinations (i.e., forms of tingling, burning).
• Somatic hallucinations (i.e., something happening inside the body such as a snake crawling inside one’s stomach)
• Visual hallucinations (i.e., vague perceptions of colour or distinct visions of people or objects).
• Gustatory hallucinations (i.e., food or drink taste strange).
4. Inappropriate Effect, i.e., emotions that are unsuited to the situation.
Negative symptoms are ‘pathological deficits’
• Alogia—poverty of speech, i.e., a reduction in speech and speech content.
• Blunted effect—reduced expression of emotions.
• Flat effect—no expression of emotions.
• Avolition—social withdrawal.
Psychomotor Symptoms:
• Schizophrenics move less spontaneously or make odd gestures. These symptoms may take extreme forms known as catatonia.
• Catatonic stupor: motionless and silent for long stretches of time.
• Catatonic rigidity: maintaining a rigid, upright posture for hours.
• Catatonic posturing: assuming awkward, bizarre positions for long periods.
