Schizophrenia symptoms | Mental health | NCLEX-RN | Khan Academy

– [Voiceover] Schizophrenia is essentially this disorder that’s present all the time, or sometimes we say that it’s chronic, and it’s characterized by someone not being able to tell what’s
real and what’s not real. And it affects about 1% of
the general US population, or about three million Americans, with an onset typically happening around the late teens to early 20s. And this is onset is usually brought on by some sort of stressful life event, like starting a new job
or going off to college. But about 15 to 20% of cases account for either late onset, which
is above 40 years old, or very late onset, above 60 years old. Clinically though, schizophrenia’s
actually a syndrome, meaning that people can have
different types of symptoms. So even like different
types of hallucinations, or delusions, but they’re all
associated with schizophrenia. So when we talk about
symptoms of schizophrenia, we can separate them into
positive and negative symptoms. And when we say positive
and negative though, we don’t mean like these positive symptoms are good symptoms, and negative are bad, we mean that these positive symptoms are usually like exaggerations
of normal processes that we typically wouldn’t see in a quote, unquote, healthy person. So you can sort of think of
it like you’re adding to, and exaggerating normal behaviors to where they become abnormal. Negative behaviors, on the other hand, are called negative
because there’s this, like, absence, or reduction in
normal processes and behaviors. It’s like you’re subtracting
from normal processes to where they become abnormal. Okay, so positive symptoms, which are also symptoms of psychosis, are things like delusions,
which are these false beliefs that someone feels very strongly about, and they won’t change their mind even though there’s strong
evidence against it. For example, a delusion of control where they think some outside force, or person, or thing, is
controlling their actions, or maybe like a delusion of reference, where they think that someone is trying to speak directly to them through a television news program,
or something similar. And another positive
symptom is hallucinations, which are any kind of
sensation, usually hearing, or seeing something,
that appears very real, but in fact, isn’t real. So maybe like hearing voices, or commands, that aren’t actually there. And finally there’s disorganization, which is either in your behavior, which someone can directly
see by the way you act, or thinking, which can be
observed through your speech. And this could be like having
trouble staying on topic, or having trouble answering the actual question that was asked. So those were all
positive symptoms, right? Where normal behaviors and processes are, like, added to, and exaggerated. But negative symptoms, where there’s this, like, reduction, or
subtraction in normal processes can be split into primary and
secondary negative symptoms. And primary negative symptoms are the core features of schizophrenia, and the first major one is apathy. And this is where the
patient lacks interest, or enthusiasm, or care towards
something or someone else. For example, not caring whether you pass this huge exam at school shows
apathy toward that class, and this is negative because
they have less interest or care than what would
be considered normal. Another major symptom is flat affect, and this is where a patient doesn’t have an emotional response,
like anger, or sadness, to situations that would
normally cause strong emotions. For example, if someone is fired
unexpectedly from their job usually you’d expect them
to be pretty angry, right? But maybe someone with
schizophrenia’s reaction would be completely unchanged,
or essentially flat. And some other symptoms
are lack of energy, and anhedonia, which is
an inability to experience pleasure from activities
that you used to enjoy. So like for example, if
you used to really enjoy going on roller coasters, and you’d have a really awesome time doing this, but now maybe you’re unable to experience the same feeling of
awesomeness as you did before. So those were primary negative symptoms. Secondary negative symptoms are any symptoms that result from other manifestations of schizophrenia. So maybe something like social isolation, or staying inside because you’re paranoid that someone is watching you. This is negative because
your actions are reduced compared to a quote,
unquote, healthy individual, and secondary because it’s
caused by paranoid delusions. All of the symptoms listed
though are mental symptoms, but there can be physical
manifestations too, which is something called catatonia. This is characterized by
changes in muscle tone and muscle activity, and
this can happen though with a lot of different
disorders, psychiatric or not, including schizophrenia, and it may be caused by medications, but other times it could be
caused by something unknown. And one type of this is catatonic stupor, which is a decreased reaction to stimuli, like not talking, or being motionless, or just staring off into the distance. And another type is excited catatonia, where you have excessive
motor activity and movements, but these movements don’t
serve any real purpose. It’s just like this general
state of restlessness.

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