What is schizophrenia?

Schizophrenia is a mental disorder interfering with a person's ability to recognize what is real, manage his or her emotions, think clearly, make judgements and communicate.

People with schizophrenia usually suffer strange symptoms, such as hearing imaginary voices, and believing that these voices are controlling their thoughts and actions. They may believe that people are plotting to harm them. They become frightened and withdrawn. Their speech and behaviour become disorganized.

The onset of schizophrenia is generally gradual, and rarely sudden or dramatic. Certain symptoms can develop slowly, in an almost imperceptible fashion, while other symptoms develop more rapidly and are very easy to recognize.

Scientists have classified the symptoms of schizophrenia as positive and negative. 'Positive' does not imply that the symptoms are 'good' for the patient, but that they are easily noticeable, more disruptive to the family, more distressing to the patient and make the patient more responsive to medicines. Some of the positive symptoms are hallucinations, delusions and thought disorders.

The negative symptoms are not easily discernible and are not very disruptive socially, but can be more disabling than the positive symptoms. Patients with these symptoms are generally less responsive to medicines. Reduced motivation and drive, difficulty in experiencing pleasure, lack of emotions and lack of energy are some of the common negative symptoms. The patient displaying these symptoms is often taken to be deliberately lazy or not making an effort, and the family may turn hostile towards him/her on account of these symptoms.

Behavioural changes

A common manifestation is behavioural change. Often, this is more easily recognized by the family members, who then take the patient to a doctor. Behavioural change could take different forms, such as social withdrawal, isolation, restlessness, irritability, aggressiveness and antisocial behaviour. These result in an impairment of day-to-day functioning - a drop in school attendance and performance, increasing unproductivity, difficulties in interpersonal relationships, neglect of household activities and preoccupation in a personal world are the common manifestations seen in clinical practice.

Description of a person suffering from paranoid schizophrenia by a neighbor

"He is a young man of 25. He used to be very good looking, but now he is dirty, does not bathe or shave, uses vulgar language, keeps shouting at people and it appears he is talking to himself. He is worse on full moon days...

People say he has gone mad, because an evil spell has been cast over him. The village people say it is to punish his family.

He has been like this for 5 to 6 years. In the beginning, he was taken to a magician, then to a faith healer who lives far away in the mountains, but he did not improve. This year, he was taken to hospital and now he is much better."