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What are positive symptoms of schizophrenia?

Douglas E. Severance, MD
Family Medicine
Positive symptoms of schizophrenia include hallucinations, delusions, and other psychotic behaviors. Positive symptoms refer to experiences that are not based in reality.

Hallucinations are one example of positive symptoms. People hear, see, feel, or smell things that are not real. The most common hallucination associated with schizophrenia is hearing voices. Another positive symptom of schizophrenia is delusional thinking. Delusions refer to beliefs and paranoid thoughts that do not make sense. For instance, some people with schizophrenia believe that aliens have invaded their body and are controlling their thoughts. Others with delusions may have paranoid beliefs that a friend or relative is plotting an attack.

Some people with schizophrenia have positive symptoms called thought disorders. Individuals with thought disorders may have trouble communicating effectively, stop talking mid-sentence, or sound confused when they speak. Tics and catatonia are movement disorder symptoms of schizophrenia. An person with tics may appear agitated or move his or her body in repetitive ways. A person with catatonia may be motionless and uncommunicative.
Symptoms of schizophrenia categorised as "positive" (something is present which should not normally be there) include:
 
  • Hallucinations: The individual with schizophrenia may hear voices or see visions that aren't there or experience unusual sensations on or in his/her body. Sometimes the voices are complimentary and reassuring; sometimes they are threatening and frightening. The voices may also instruct the individual to do things that he/she wouldn't normally do and may be harmful.
  • Thought disorder: The way a person with schizophrenia processes thoughts can be very different from the way others do. Thinking is often disorganised and fragmented and the person's speech may be illogical or incoherent. The person may feel that his/her thoughts are racing through his/her mind and that it is impossible to catch up. Often inappropriate responses may exist with this disorder: the person may be speaking of something sad or frightening and be laughing at the same time.
  • Delusions: The individual has strange, unrealistic beliefs that are inappropriate for their culture and persist, despite evidence to the contrary. The person may believe that he/she is getting instructions from space aliens or being watched by others who will inflict harm. It is not effective to argue against the delusions as they are very real to the person, no matter what others may say. Delusions can be primary or secondary. A secondary delusion is an interpretation of an illusion or hallucination. If the person hears the voice of a police agent ("an auditory hallucination") they may form a delusion that they are under police surveillance. A primary delusion is an unrealistic belief that just seems to appear from nowhere. More than 90% of patients with schizophrenia will experience delusions at some stage.
  • Altered sense of self: The person may feel that his/her body is separated from the inner self and be unable to tell where the body ends and the rest of the world begins. This causes confusion in the person as to who he/she is and may cause feelings of being nonexistent as a person.
  • Memory impairment: The individual may recall that an event occurred but be unable to remember the specifics, such as where, when, or how it took place. In addition, a distraction may cause a person to forget a preceding event.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.