Module 4 - Schizophrenia and Other Psychoses

Features of Psychosis - Positive Symptoms

The positive symptoms of schizophrenia are hallucinations, delusions and thought disorder that occur during acute episodes of illness and often cause significant behavioural disturbance. Positive symptoms tend to respond to, antipsychotic medication. There are many sorts of positive psychotic symptoms and some of the ones important in schizophrenia are described below. Delusional perception occurs when a person has a normal experience and their understanding of what has occurred is false, odd and of high personal importance. The psychotic belief may be described as occurring suddenly or out of the blue. An example of delusional perception is a person’s sudden conviction that they are an important messenger from God after seeing a bright ray of sunshine break through some clouds. Passivity of thought refers to beliefs that the person’s thinking processes are controlled by external forces. Examples are given below: The person may experience their mind going suddenly blank and believe that their thoughts have been removed from their mind. This is thought withdrawal. The person may experience thoughts which do not feel like their own and believe that thoughts have been placed in their mind. This is thought insertion. The person may believe that their thoughts are not contained in their mind and that they are being broadcast to or shared by others. This is called thought broadcast or thought sharing. People can also believe that their feelings, actions, choices and sensations are unfamiliar and not within their control and these are the other passivity experiences. People who experience passivity symptoms often develop delusional beliefs about hidden transmitters, recording devices, implants and magic and they may believe they are being controlled by specific people who are trying to harm them (e.g. police, security forces, criminals or fantasy figures like witches). Auditory hallucinations are common and include the person hearing their thoughts spoken aloud as they think them (thought commentary or echo); hearing voices discussing or arguing about the person and voices giving a running commentary on what the person is doing (e.g. “he is having his breakfast now”.)
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