could you share any more under-talked about symptoms of schizophrenia, like executive dysfunction?
I've actually been meaning to make a post like this but keep forgetting (lol that's a symptom). As a disclaimer, not everyone with schizophrenia has every one of these symptoms, and people can have a lot of these symptoms and not have schizophrenia (if they don't have the psychotic symptoms). Not all of these symptoms are seen as diagnostic criteria, some have just been observed to be very common in people with schizophrenia. (I'm excluding hallucinations and delusions because they are more well known)
β’ Paranoia: a pattern of behavior where a person feels distrustful and suspicious of other people and acts accordingly. This can go hand in hand with hallucinations and delusions.
β’ Disorganized thoughts: this can mean a lot of things. It can be not having a linear train of thought, having incoherent thoughts, thought blocking, general disorganized thoughts. (It can be hard to define because it is often hard to describe for the person experiencing it).
β’ Disorganized speech: this is often a result of the disorganized thoughts. This can include loose associations like rapidly shifting between topics with no connections between the topics. Perseveration, which is repeating the same things over and over again. Made up words that only have meaning to the speaker. Use of rhyming words without meaning. Word salad, which is when cognitive disorganization is severe, it can be nearly impossible to understand what the person is saying, but the person speaking doesn't know they aren't making sense.
β’ Trouble concentrating: lack of concentration, switching from topic to topic, not being able to focus on one thing. (This is pretty self explanatory).
β’ Movement disorders: catatonia can be repetitive non goal directed movements. It can also be complete or partial immobility, mutism, vacant staring, and rigidity. Although not a symptom, tardive dyskinesia can occur in schizophrenia as a result of antipsychotics medication.
β’ Anhedonia: a loss of pleasure in activities that the person once enjoyed. Or the inability to feel pleasure at all.
β’ Atypical or non-existent emotional expression: Flat or blunted affect is an inability to show emotions characterized by a lack of facial expression, a monotone voice, and no hand gestures. On the other hand people can also have inappropriate affect, where the emotional expression doesn't align with typical reactions or even the person's own feelings.
β’ Alogia: when someone speaks less, says fewer words or only speaks in response to others. This can be a result of disorganized thoughts.
β’ Social withdrawal: avoiding people and activities that someone once enjoyed. Not actively being present during social situations. Can progress to total isolation.
β’ Avolition: a severe lack of initiative to accomplish purposeful tasks. This is a big reason some people with schizophrenia can't work/go to school, can't do chores, and can't keep up with their basic hygiene. Even if the person wants to do these tasks, it may be extremely difficult or impossible for them to get themselves to start or complete the task due to the lack of motivation.
β’ Executive dysfunction: a behavioral symptom that disrupts a person's ability to manage their own thoughts, emotions and actions. This can include focussing too much on one thing, being easily distracted, spacing out, struggling to switch between tasks, problems with impulse control and trouble starting difficult or boring tasks. Several schizophrenia symptoms fit into the umbrella of executive dysfunction, so when researching you will either see the specific ones listed out, or just simply described as executive dysfunction.
β’ Alexithymia: significant challenges in recognizing, expressing, and describing one's own emotions.
β’ Poor memory: this can include working memory deficits like trouble planning, organizing, and carrying out daily chores such as running errands, because it requires mentally formulating a βto doβ list organized by time and location. Many people with schizophrenia also report trouble with their episodic memory, which means they have trouble recollecting things in the context of their place and time. (A lot of sources say "trouble with memory" is a symptom but they don't specify).
β’ Trouble with decision making: people with schizophrenia have been shown to have trouble with decision making due to a decline in the understanding and reasoning aspects of it.
β’ Sensory processing deficits: this has been widely reported in schizophrenia, and include impairments in visual processing, auditory processing, olfactory and sensorimotor systems. This can lead to having strong positive or negative reactions to sensory information.
β’ Sleep troubles: though disturbed sleep isn't included in the diagnostic criteria for schizophrenia, it is still a significant problem that up to 80% of people with the condition experience. People with schizophrenia may have various sleep problems, including insomnia, excessive daytime sleepiness, and trouble with consistent sleep routines.
β’ Anosognosia: also called "lack of insight," is a symptom that impairs a person's ability to understand and perceive their illness. This is a big reason people with schizophrenia may refuse to get, or stay with treatment.
