"Schizophrenia represents a psychiatric disorder that is often first detected in late adolescence/early adulthood," says Gary Remington, head of the Schizophrenia Program at the University of Toronto. "It is felt to be, at least in part, biological, although environmental factors like stress and drug use are also felt to play a role."

The disorder, he says, is characterized by changes in behaviour and thinking, so symptoms can be diverse. Some include depression and unusual thoughts that can lead to prominent alterations in mood and behaviour.

Because of the wide range of possible symptoms, Remington notes there are no specific biological 'markers' in diagnosing schizophrenia. Instead, identification is based on clinical examination and the finding of a cluster of symptoms that fit the diagnosis. As many of the symptoms are not unique to schizophrenia, it is important to consult a doctor for diagnosis.

Symptoms
Like many illnesses, schizophrenia is considered to be a lifelong disorder that benefits from early intervention and ongoing care. Here, Remington, who also works with the Centre of Addiction and Mental Health, breaks down the symptoms of the disorder into 4 different classes.

1. Positive
"Positive symptoms are characterized by unusual interpretations of the surrounding environment," explains Remington. The two most common symptoms in this category are delusions and hallucinations. Delusions can be described as having beliefs not based on fact. These beliefs can include a sense of paranoia or having special powers, says Remington. People experiencing delusions may believe that their bodies are being controlled by outside forces and may be wary of the people around them.

Hallucinations are disturbances in perception. If people hear, see, taste, smell or feel something that does not actually exist, they may be hallucinating. The most common hallucinations are auditory. "As one might imagine," says Remington, "such experiences can result in people sounding or acting quite unusual or even bizarre."

2. Negative
Negative symptoms relate to loss of functioning, says Remington. People may become withdrawn, demonstrate a lack of motivation and lose interest in activities they may have been interested in previously.

3. Cognitive
Cognitive symptoms can vary from subtle changes in behaviour and concentration to serious disorganized thinking, which may be reflected in a person's speech.

4. Affective
Affective symptoms can be described as changes in mood. The most common of these is depression, says Remington, although the individual may also experience significant anxiety. Irritability and aggression are also common among people with schizophrenia. These two symptoms, Remington says, can reflect misinterpretations of the surrounding environment. "[There is a] frustration that others cannot appreciate what they are experiencing and are trying to talk them out of what they feel are real experiences."

Helpful resources
If you or anyone you know are experiencing these symptoms, or for more information on the causes, symptoms and treatments of schizophrenia, consult:

• The Centre for Addiction and Mental Health (CAMH) has accessible information on mental illnesses, possible treatments and how to seek help.

• Mental Health Canada is a directory of Psychologists, Psychiatrists and Counsellors from all across Canada.

• The Schizophrenia Society of Canada provides information and support for people battling schizophrenia.

• Canadian Mental Health Association

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