Common Symptoms

Psychotic symptoms usually occur every now and then with periods of remission. They typically occur in men ages 17 - 30 and in women ages 20 - 40.

Cognitive Impairment (Disordered Thinking)

The symptoms of cognitive impairment and disordered thinking may occur before other symptoms of schizophrenia. They include:

• A lack of attention.
• Impaired information processing and an aberrant association between words and ideas. Sometimes this condition is so extreme that speech becomes incoherent and is referred to as "word salad." Patients may connect words because of similarity of sound, rather than by meaning, a condition known as "clang associations."
• Memory impairment. In keeping with other aspects of disordered thinking, memory impairment in schizophrenia is likely to involve the inability to connect an event with its source into a complete and whole memory. For instance, a patient may recall and even feel a familiarity with a specific event but be unable to remember where, when, or how it took place.
• Backward masking dysfunction. This is a trait in which a distraction causes a person to forget a preceding event. It might be an important symptom and a marker of schizophrenia even in people with normal working memories.

People with schizophrenia do poorly on mental tasks requiring conscious awareness, such as verbal fluency, short-term and working memory, and processing speed. However, they are no worse than the general population in underlying (implicit) learning, such as grammar skills, vocabulary, and spatial skills (such as map reading). Some experts believe that impaired verbal memory in schizophrenia is a consequence of depression and slowness, but not a result of the disease process.

Other Symptoms

People with schizophrenia may experience other symptoms, such as intolerance of heat (often associated with antipsychotic medications) and a reduced sense of smell.

Symptoms of Progression to Full-Blown Schizophrenia

The course of the disease varies from one patient to the next. Symptoms of psychosis can become gradually or suddenly evident.

• In up to a third of patients, the disease is unrelenting and progresses from the first episode onward.
• In others, schizophrenia follows a fluctuating course with psychotic flare-ups, followed by remissions.
• In one study, 31% of patients experienced a complete remission of symptoms within 3 years after one or more episodes. Women are more likely to go into remission, possibly because of some protective effect of estrogen on the brain.