Symptoms

Cognitive disorders are often the first symptoms to appear and they are the early warning signs of schizophrenia. They are also called precursor symptoms. These are the disorders that lead to socializing difficulties in people affected by schizophrenia.

• Attention disorders, lack of concentration and effort tolerance
  

The person takes time to answer questions, to react to situations that call for a rapid response; he is unable to sustain attention on a task and no longer able to continue his studies or concentrate on a film.

• Memory disorders

He forgets to perform daily tasks (homework, follow a schedule). He has difficulty relating what he is reading, remembering what others say, or following a conversation. His autobiographical memory is affected: he forgets events in his personal history. His impaired working memory means that he cannot do several tasks at the same time since he cannot remember how far he has progressed on each task.

• Executive function disorders

Executive functions are essential to all directed, autonomous and adapted behaviour, such as preparing a meal. He has difficulty conceptualizing the actions needed to accomplish a task or anticipate the consequences: he cannot plan and organize the series of steps needed to reach a goal; he also lacks flexibility, discernment, verification, and the ability to correct himself.

Cognitive disorders occur first, as precursor symptoms, but they persist long after the positive symptoms have diminished.

The appearance of acute (positive) symptoms is usually in early adulthood, between ages 17 and 23 in men, and between ages 21 and 27 in women. They are called ‘positive’ because they are manifestations that are added to normal mental functioning. It is their presence that is abnormal.

• Hallucinations

These are disturbances in perceptions, most often auditive (the person hears a voice that utters insults and threats), but sometimes they can also be visual, olfactory or tactile.

• Delusions

These are errors in logical judgment, beliefs not grounded on reality.
The person imagines that someone looking at him in the bus, or someone he passes in the street is there to spy on him; he feels watched, persecuted, in danger or he believes the television is sending him messages; he is convinced he has the power to influence world events, that he is controlled by a force or that others can read his thoughts, etc. 

• Incoherent language

He says things that are incoherent or incomprehensible and invents words.

• Bizarre acts

The person closes the blinds of the house for fear of being spied on; collects empty water bottles, walks nude in the street, shows an unusual interest in religions and occult sciences, etc.

• Compulsive need to write; writes incoherent texts with handwriting similar to that of a child

Negative symptoms usually follow positive symptoms. They can be seen in a lack or absence of expected, spontaneous behaviours. Negative symptoms are often wrongly attributed to the effects of medication.

• Isolation, social withdrawal, indifference to the outside world

The person loses pleasure in recreational activities. He abandons his friends, withdraws to his room, even becomes irritable if someone tries to approach him. Little by little he cuts himself from reality. His interpersonal relationships deteriorate.

• Alogia or difficulty conversing

He can no longer find words, gives brief and evasive answers and is no longer able to communicate his ideas or emotions. He uses unusual expressions or sentence structures.

• Apathy, loss of energy

The person spends his days in front of the TV without being able to follow what is happening. He neglects his personal hygiene and appearance and lacks interest and persistence in beginning and completing routine tasks (studies, work, housework). His attitude gives the impression of carelessness, negligence, of laziness, of a lack of will.

• Reduced expression of emotions

The face of the person affected becomes blank, his vocal inflections diminish (he always speaks in a monotone), his movements are less spontaneous, his actions less demonstrative. He has a fixed stare, along with an absence of blinking or, alternatively, incessant blinking.

• Social and occupational dysfunction

All these symptoms lead to a dysfunction in hygiene, studies, work, and interpersonal relations. Some of these symptoms and changes in functioning may persist off and on for years.
 

• Sleep disorders, periods of wakefulness at unusual hours, confusion of night and day.
• Hyperactivity or inactivity or alternating between the two states.
• Hostility, distrust and terror.
• Exaggerated reactions when faced with disapproval from friends, colleagues and family members and unusual emotional reactions.
• Hypersensitivity to sound and light.
• Alterations in taste and smell.
• Self-mutilation