Delusions:

Delusions are distorted thoughts that often involve misinterpretations of reality.  The four most common types of delusions are:

1. Persecutory: when one thinks he/she is being followed, tricked, spied on or ridiculed
2. Referential: he/she thinks that certain song lyrics, gestures, comments etc. are aimed at them
3. Delusions of Grandeur: one believes themselves to be  someone of great power (a deity or a great savior)
4. Delusions of Control: where people think that their thoughts, feelings and actions are being controlled by others

It is important to differentiate between delusions and strongly held beliefs because one is a characteristic of people with schizophrenia, while the other is a characteristic common to most of the population. 

Delusions are “bizarre” and relate to schizophrenia if they express a loss of control over one’s body or mind.  For example, if a woman said that the FBI had removed her brain and internal organs, we would know that this was a bizarre delusion because it is impossible and there is an obvious loss of control over this patient’s mind/body.

Hallucinations:

There are many different types of hallucinations: auditory, olfactory, visual and tactile, but the most common type of hallucination is auditory.  Auditory hallucinations are usually obvious in patients because they hear familiar and unfamiliar voices in their head, usually carrying on running commentary.  It is important that these hallucinations are experienced while one is awake and while they have all of their senses, so they are not mixed up with dream like hallucinations.

Disorganized Speech:

People with schizophrenia show disorganized speech in a few main ways:

• They slip off topic quite easily 
• They respond to questions with unrelated answers
• Their speech is so disorganized it can be incomprehensible—“word salad”

Disorganized/Catatonic Behavior:

This type of behavior can be seen in people with schizophreinia who display childlike silliness, unpredictable agitation, messy and disheveled physical appearance, inappropriate sexual behavior and those who experience difficulty in goal-directed behavior/difficulty in day to day tasks.

These people with schizophrenia are often less reactive to the environment (catatonic).  Sometimes they are completely unaware of people and objects around them.  Also, their bodies can take on a stiff posture, not wanting to be moved.  Patients can also take on inappropriate or odd postures.

Affective Flattening:

This negative symptom is seen when people with schizophrenia have difficulty expressing their emotions.  Their facial expressions seem to be unresponsive.  They tend to have poor eye contact, monotonous voices and express themselves with less/no body language.  Their entire range of emotional expression is also reduced.

Alogia:

People experiencing this sort of symptom will respond with brief, empty replies.  People who experience alogia also seem to have fewer thoughts, which is seen through their decreased fluency and production of speech. 

Avolition:

These individuals have little or no interest in being  part of social activities or the work field.