The first signs
of the disorder are usually confusing or shocking changes in
behavior. This is especially difficult for family members who
remember how this individual used to be. Severe psychotic symptoms
which can occur are referred to as an “acute” phase
of schizophrenia. “Psychosis” which is common for
schizophrenics, is a state of mental impairment defined by hallucinations
or disturbances of sensory perception, and/or delusions, which
are false yet strongly held personal beliefs resulting from
an inability to separate real from unreal experiences.
Social isolation or withdrawal, unusual speech, thinking, or
behavior, may proceed, be seen along with, or follow the psychotic
symptoms. Some people have only one psychotic episode; others
have many episodes during a lifetime, but lead relatively normal
lives during the interim periods. However, the individual with
“chronic” schizophrenia, or a continuous or recurring
pattern of illness, often does not fully recover normal functioning
and typically requires long-term treatment, generally including
medication, to control the symptoms.
Making an accurate diagnosis can be difficult because different
symptoms may be reminiscent of other illnesses. For this reason,
it is important for a clinician to perform a complete medical
and psychological history of the patient in question. Medical
history or commonly abused drugs can mimic symptoms of schizophrenia
so blood or urine samples need to be tested at a hospital in
addition to already noted histories that need to be taken. Some
people with symptoms of schizophrenia exhibit prolonged extremes
of elated or depressed mood, and it is important to determine
whether such a patient has schizophrenia or actually has a manic-depressive
(or bipolar) disorder or major depressive disorder. Persons
whose symptoms cannot be clearly categorized are sometimes diagnosed
as having a “schizoaffective disorder.”
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