Modes of awareness associated with schizophrenia

(1) Delusions: Thoughts are disturbed so that there may be multiple, fragmented or bizarre delusions. Events, objects or other people may seem especially significant, usually in a negative way. There is a feeling that one's thoughts are broadcast so that others hear them, that thoughts are inserted into or withdrawn from one's head, that thoughts, feelings, impulses and actions are imposed by some external force.

(2) Disorder of thought form: Ideas shift from one thing to another with little or no connection so that communication becomes confused, apparently meaningless or incoherent.

(3) Hallucinations: There are major disturbances in perception, particularly the hearing of voices outside the head, which may be making derogatory remarks or commands which must be obeyed despite danger to the hearer or others. Hallucinations involving the other senses also occur, together with perceptual abnormalities such as a feeling of bodily change and synaesthesia.

(4) Affective disturbance: There may be flat affect, with lowered emotional response or no feelings at all; or there may be inappropriate affect, out of harmony with the person's ideas or speech.

(5) Ego-loss: The sense of unique self-hood is disturbed so that the person is confused about his or her identity and the meaning of existence.

(6) Volitional disturbance: interest and drive are diminished so that activity is not goal-directed and the individual cannot function in a role-playing manner.

(7) Withdrawal and detachment: The person is preoccupied with internal delusions, fantasies and ideas, these distorting or excluding the outside world and causing difficulties in personal relationships.

(8) Catatonic and psychomotor disturbances: There may be catatonic stupor with apparent unawareness of the environment, rigidity, extreme flexibility, bizarre movements and postures unrelated to external circumstances, resistance to being moved, odd mannerisms, facial grimaces.