Hallucinations are a positive symptom, in most cases the



hallucinations suffered by schizophrenics are not the usual visual

hallucinations I would imagine most people experience when ill with a

temperature. The most common hallucinations in schizophrenics are

auditory hallucinations, usually consisting of one or more voices,

which may speak to them directly, but quite often the voices are not

directed to them, but do concern them, usually in a derogatory way,

making suggestions to harm themselves or others, criticizing, or

giving a running commentary on their own thoughts and actions.

Hallucinations can involve any of the senses, such as visual,

olfactory and tactile hallucinations, but auditory are the most common

in schizophrenics .

Delusions, which are false irrational beliefs, not based on reality,

can take many forms, the schizophrenic may be deluded that they are

more powerful or important than any other human, that they have god

like powers or knowledge, they may believe they are a person from

history; these delusions are referred to as delusions of grandeur

They may experience paranoid delusions, that they are

being persecuted and that someone or something is conspiring against

them, or trying to harm them.

Negative symptoms include flattened emotional response, where almost

no stimuli will provoke an emotional response; they will continue to

speak in a flat toneless voice, this affect appears to only affect a

schizophrenic's external emotional appearance and not their internal

emotions and feelings. schizophrenics may suffer with

poverty of speech and be restricted in the spontaneity and information

in their speech Schizophrenics may suffer with

anhedonia, an inability to experience any pleasure from activities

that may have previously been pleasurable, leading to a lack of

interest in recreational activities. They fail to develop close

relationships and become socially withdrawn; they lack social skills

and lack an interest in being with people. The schizophrenic may find

that they lack energy and motivation and have no interest in the way

they look and their personal hygiene.

Disorganised symptoms include bizarre behaviour, thought disorders and

disorganised speech. Irrational and disorganised thoughts are probably

the most important symptoms of schizophrenia, they will have

difficulty in organizing their thoughts, and find

it difficult to sort out from logical thoughts and non logical

thoughts that any non schizophrenic would know where unreal and

ridiculous

Thought possession or insertion, the schizophrenic patient believes

that thoughts are not his own and are being placed in his mind by

someone or something else such as aliens or god. Thought withdrawal,

Schizophrenic patients may also believe that their thoughts are being

removed by some kind of phonological machinery, aliens or God and that

these thoughts may be broadcast or read by others. The schizophrenic

patient may also suffer with thought blocking, where they may have a

thought, and be talking about it, and then suddenly stop and not

remember what they were saying or thinking. They

may have problems with learning and will find it harder to concentrate

whilst reading or watching television.

A schizophrenic whilst in conversation will change from one subject to

another, Words may take on special meanings to them, either because

they trigger private associations or because they pay particular

attention to individual sounds rather than whole words for example

'Psychiatry' Might be heard as 'sigh kaya tree' so the schizophrenic

will change the subject from psychiatry to mystical trees

also they may avoid some words because they sound abusive or evil. A Schizophrenics

speech may seem incomprehensible to a non schizophrenic; they will

make up meaningless words, or use words which rhyme rather than making

any sense .

Schizophrenics seem to lack the ability to behave in a socially

acceptable way, they may collect and hoard items, sometimes even

rubbish, some dress in a strange way and some are known to behave in a

childlike manner or even behave in a sexually inappropriate way.

Symptoms that don't seem to belong to the three categories such as

catatonia, which is a motor symptom, such as positioning themselves

into a strange bodily position and remaining motionless and waxy

flexibility, where their limbs can be molded into

position like a statue and remain motionless for a long period of

time. Negativism, which is resisting attempts and suggestions, for no

apparent reason, to move or be moved or doing the exact opposite to

what is requested. A patient with ambitendence

will begin a movement such as going to shake a persons hand and then

appear to change their mind and take the hand back

Echopraxia, constant mimicking of a person when requested not to.

Stereotypies, regular repetitive movements for no apparent reason

'e.g. moving the arm backwards and outwards repeatedly while saying

'but not for me'.

Abnormalities found in the brains of schizophrenics may be due to

genetic factors or due to the effects from environmental factors,

studies have found that the lateral ventricular in a

schizophrenic patient is around 25% larger than normal, although their

actual brain is fractionally smaller and has a reduced cortical volume

mostly in the temporal lobes, basal ganglia and limbic structures and

also sulcal widening. It has been found that

schizophrenic patients have structural faults in the temporal cortex,

hippocampus, basal ganglia and the prefrontal cortex which also has a

reduction in grey matter and a slow metabolic rate. It has been

suggested that during the second trimester of the foetal development

that there is some failure in neuronal migration.

The largest risk factor for developing schizophrenia is genetic. The

main studies on twins by Gottesman show that monozygotic twins

have a greater risk at 48% of both developing schizophrenia compared

to dizygotic twins which have 17% chance of developing

schizophrenia, although this can not be proved

without doubt because monozygotic twins would be treated similarly by

parents and would share the same environmental influences Adoption

studies backup the theory Tienari studied

155 adopted children whose natural mothers were schizophrenic. When

followed up years later he found that 10.3% had developed

schizophrenia, compared with only 1.1% of those without schizophrenic

mothers. Parnaset backs up this theory; he studied 207 children

with schizophrenic mothers and followed them up nearly 30 years later

16% developed schizophrenia compared to a low risk group which only 2%

developed schizophrenia . Evidence has been found

by Sherrington et al of a group of genes on chromosome 5 that

might be the reason for a person being susceptible to developing

schizophrenia, but it has yet to be confirmed .

The symptoms of schizophrenia are so varied from self neglect and

social withdrawal, to delusions and hallucinations, and not all being

present in every case. The wide range of abnormalities in the brain

could possibly explain why there is such a wide range of symptoms.

Considering all of the genetic and environmental factors that play a

role in its occurrence research seems to point towards genetics being

the main factor and environmental factors playing a part in triggering

the onset of schizophrenia.