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Question
While speaking in public the patient changes topics frequently, is this a positive or a negative symptom of schizophrenia? Describe the other symptoms of schizophrenia.
Solution
Positive symptoms :- These are ‘pathological excesses’ or ‘bizarre additions’ to a person’s behaviour. Delusions, disorganised thinking and speech, heightened perception and hallucinations, and inappropriate affect are the ones most often found in schizophrenia.
Negative symptoms :- These are ‘pathological deficits’ and include poverty of speech, blunted and flat affect, loss of volition, and social withdrawal. People with schizophrenia show alogia or poverty of speech, i.e. a reduction in speech and speech content. Many people with schizophrenia show less anger, sadness, joy, and other feelings than most people do. Thus they have blunted affect. Some show no emotions at all, a condition known as flat affect. Also patients with schizophrenia experience avolition, or apathy and an inability to start or complete a course of action. People with this disorder may withdraw socially and become totally focused on their own ideas and fantasies.
Sub-types of Schizophrenia :-
According to DSM-IV-TR, the sub-types of schizophrenia and their characteristics are :-
- Paranoid type :- Preoccupation with delusions or auditory hallucinations; no disorganised speech or behaviour or inappropriate affect.
- Disorganised type :- Disorganised speech and behaviour; inappropriate or flat affect; no catatonic symptoms.
- Catatonic type :- Extreme motor immobility; excessive motor inactivity; extreme negativism (i.e. resistance to instructions) or mutism (i.e. refusing to speak).
- Undifferentiated type :- Does not fit any of the sub-types but meets symptom criteria.
- Residual type :- Has experienced at least one episode of schizophrenia; no positive symptoms but shows negative symptoms.
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