The clinical symptoms of schizophrenia are complex and diverse, which can involve perception, thinking, emotion, will and behavior and cognitive function. Symptoms vary greatly among individuals, and even the same patient may show different symptoms at different stages or stages.
(1) Sensory disorder Schizophrenia can have many sensory disorders, and the most prominent sensory disorder is hallucination, including auditory hallucination, auditory hallucination, olfactory hallucination and tactile hallucination, among which auditory hallucination is the most common.
(2) Thinking disorder Thinking disorder is the core symptom of schizophrenia, which mainly includes thinking form disorder and thinking content disorder. The obstacle of thinking form is mainly manifested in the obstacle of thinking association process, including the obstacle of thinking association activity process (quantity, speed and form) and the coherence and logic of thinking association. Delusion is the most common and important obstacle to thinking content. The most common delusions are delusion of victimization, delusion of reference, delusion of influence, delusion of jealousy, delusion of exaggeration, delusion of non-descent, etc. It is estimated that as many as 80% of schizophrenics have delusions of victimization, which can be manifested in varying degrees of insecurity, such as being monitored, being rejected, fearing being drugged or murdered. Under the influence of delusion, patients will act defensively or aggressively. In addition, some patients' passive experiences are also outstanding, which have an impact on their thinking, mood and behavior.
(3) Emotional disorder, apathy and uncoordinated emotional response are the most common emotional symptoms of schizophrenia. In addition, emotional symptoms such as uncoordinated excitement, irritability, depression and anxiety are also common.
(4) Will and Behavior Disorders Most patients have reduced or even lack of will, which is manifested in reduced activities, solitude, passive behavior, lack of due enthusiasm and initiative, decreased interest in work and study, indifference to the future, and no clear plan for the future. Some patients may have some plans and plans, but they seldom carry them out.
(5) The incidence of cognitive impairment in schizophrenic patients is high, and about 85% patients have cognitive impairment such as information processing and selective attention, working memory, short-term memory, learning and executive function. Cognitive impairment symptoms are related to other psychotic symptoms, such as cognitive impairment symptoms are more obvious in patients with obvious mental disorders, cognitive impairment symptoms are more obvious in patients with obvious negative symptoms, and cognitive impairment may be related to the production of some positive symptoms. Cognitive impairment may occur before psychotic symptoms become clear (such as prodromal period), or decrease sharply with the appearance of psychotic symptoms, or decrease gradually with the extension of the course of disease. It is preliminarily considered that the cognitive impairment of patients with chronic schizophrenia is more obvious than that of patients with first-episode schizophrenia.
2. Clinical classification
(1) Paranoia This is the most common type of schizophrenia, with hallucinations and delusions as the main clinical manifestations.
(2) The onset of adolescence is characterized by obvious obstacles in thinking, emotion and behavior, which are typically characterized by sloppy thinking, broken thinking, naive emotional and behavioral responses, and may be accompanied by hallucinations and delusions; Some patients can show hyperactivity of instinctive activities, such as increased appetite and sexual desire. This kind of patients have the characteristics of low initial age, acute onset, obvious social function damage and poor prognosis.
(3) Tension syndrome is the main manifestation of tension type, and patients can show tension rigidity, wax-like wrinkles, stiff words and deeds, uncoordinated psychomotor excitement and impulsive behavior. Generally, the onset of this kind of patients is more acute, and some patients relieve quickly.
(4) Simple type mainly occurs in adolescence, and it mainly shows negative symptoms, such as withdrawn, dull or indifferent emotions. This kind of treatment has poor effect, obvious decline in social function and poor prognosis.
(5) The undifferentiated type has some characteristics of one of the above types, or some characteristics of the above types, but it is difficult to be classified into any of the above types.
(6) The residual type is the stage after the acute stage of schizophrenia, which is mainly manifested in the change of personality or the decline of social function.