Understanding Positive vs. Negative Symptoms of Schizophrenia
Why This Distinction Matters
Schizophrenia symptoms fall into two categories: positive and negative. Understanding both helps families, clinicians, and individuals recognize patterns and track progress.
Positive Symptoms: Additions to Perception or Behavior
Positive symptoms are experiences added to typical functioning.
1. Hallucinations
Hearing voices is most common, but hallucinations may involve sight, smell, taste, or touch.
2. Delusions
Strong beliefs that are not based in reality. Examples:
Persecution
Grandiosity
Thought insertion
Reference (believing TV or radio messages are directed at you)
3. Disorganized Speech
Tangential thinking
Word salad
Sudden topic shifts
4. Disorganized or Agitated Behavior
Unpredictable movements
Difficulty completing tasks
Treatment Response: Positive symptoms generally respond well to antipsychotic medication.
Negative Symptoms: Loss or Reduction of Abilities
Negative symptoms reflect decreased function or emotional expression.
1. Flat Affect
Reduced facial expressions, monotone voice, or limited gestures.
2. Avolition (Lack of Motivation)
Difficulty starting or completing daily tasks—even simple ones.
3. Social Withdrawal
Avoiding interactions or losing interest in relationships.
4. Alogia (Reduced Speech)
Minimal speech output or short, simple replies.
5. Anhedonia
Reduced ability to feel pleasure or enjoy hobbies.
Treatment Response: Negative symptoms can be harder to treat and often require therapy, routine building, social skills training, and long-term support.
Why Negative Symptoms Are Often Misunderstood
Negative symptoms may look like:
Laziness
Depression
Lack of interest
Poor attitude
But they are neurological—not personality traits.
Final Thoughts
Understanding positive and negative symptoms creates a clearer picture of schizophrenia. Both types deserve empathy, support, and proper treatment tailored to the individual.
