How to recognize a person with schizophrenia. How to distinguish schizophrenia from a nervous disorder

It must be remembered that these signs mental disorders may occur in incomplete form and in other mental pathology. Or, on the contrary, in some forms of schizophrenia, there are no deceptions of perception and delusional symptoms, and only apatho-abulic syndrome is expressed - weakness of will and impoverishment of emotions. Therefore, only a psychiatrist can make a correct diagnosis during a face-to-face appointment. And in the case of schizophrenia, long-term observation is required in a psychiatric hospital.

How does schizophrenia manifest?

At the beginning, middle and end of its development, schizophrenia manifests itself in different ways. Depending on the form, the disease can begin in different ways. Paranoid and catatonic schizophrenia can manifest as a manifesto of acute psychotic disorder in quite at a young age. The simple form has a gradual course and often complete absence delusional symptoms and hallucinations.

The person gradually withdraws into himself, losing social contacts.

If there are delusional ideas, by the middle of the illness the delirium is systematized - the picture links the images with a certain logic that is understandable to the patient. By the end of the disease, when there is practically no criticism of the condition and there are signs of personality degradation, the delusion becomes broken, i.e. unsystematized. The complexity of delusional content is simplified, hallucinations lose their brightness and direction. Lack of interest in the external world leads to impoverishment of the internal world.

The progression of any type of schizophrenia sooner or later leads to the destruction of personality, aimless existence and loss of interest, both in the world around us and in oneself. The sooner it starts drug treatment, those more likely maintaining individuality and striving for social activity. Preserved Center "Preobrazhenie Clinic" offers outpatient and hospital treatment in Moscow. If necessary, you can call a psychiatrist to your home; patients can attend socio-psychological rehabilitation groups and learn to understand themselves and the external space.

How to identify schizophrenia in humans and animals

Schizophrenia and other endogenous mental illness completely absent in animals. If neurosis occurs in pets, after the experience severe stress or prolonged discomfort, then wild animals do not even have neurotic disorders. What does this mean? That animals are not prone to unproductive mental and physical activities.

All animal behavior is constructive and aimed either at gaining experience or at ensuring its livelihood. Moreover, the presence of intelligence and complex emotions has been proven in higher animals. They do not have improper upbringing, insoluble conflicts or eternal sadness about what was lost. All questions are resolved and brought to their logical conclusion. Lonely non-adaptive animals either die or get used to a solitary existence. Sorrows are forgotten, wounds heal, bones grow together - and the beast is activated again to life.

Schizophrenia definition

Schizophrenia is serious pathology behavioral-cognitive sphere, associated with deep disturbances in relationships with oneself and the world. The change of generations transmits a certain style of behavior from generation to generation, fixing it at the genetic level. In schizophrenia, thinking, attention, the area of emotions and intentions are irreversibly changed. But smooth out the changes and learn to manage your mental health possible with long-term and in-depth psychotherapy.

Does schizophrenia occur in animals?

No. And this gives us the understanding that there are no structural changes There is no brain in this disease, but there is a distorted perception of oneself and others. This speaks for the possibility of a cure for schizophrenia. But one person's life is not always enough to heal birth disease. But with each new effort the condition will stabilize and the disease will recede.

How to identify schizophrenia

Schizophrenia affects almost every area mental activity person.

Diplomas from the Russian Fund for the Protection of Consumer Rights - “ Best clinic Russia"

How to identify a schizophrenic? The manifestation of schizophrenia can be recognized by the following parameters:

An apathetic attitude towards oneself and the outside world is manifested in sloppiness and a strange style of clothing, and a lack of self-care. Patients are often unshaven with dirty hair. Loss of interest in work, disappearance of previous interests, no strength or desire to gain new experience and learn.
A person with schizophrenia stops communicating with people. Becomes colder with friends and relatives, he does not trust people. In his delusional reasoning, he ceases to need an interlocutor.
Thinking becomes fragmented and speech incoherent; phrases although they have a formal correct construction words – the very essence of the story is missing; Neologisms are invented - new words that are completely devoid of meaning.
Emotions are either contradictory and inadequate to the situation, or flattened. In patients with schizophrenia, during an exacerbation, states of freezing in unusual positions are possible. Mental and motor restlessness. Often moments of aggression are replaced by periods of good nature and submission. Anxiety due to the inability to control conditions leads to sleep disturbances and general restlessness. Depression in schizophrenia has no cause and is usually not noticeable in appearance.
Changes in behavior are manifested by unusual hobbies, eccentricity and pretentiousness, asociality with early alcoholism, running away from school, and theft. Patients experiencing hallucinations listen to something, hide, and become suspicious.

Understanding how to recognize a schizophrenic among others is very important. And not at all in order to avoid this person or make fun of him. Schizophrenia is a mental disorder that can greatly change consciousness and even force a person to take actions that are unusual for him, sometimes life-threatening. Once you determine that someone has symptoms of schizophrenia, you can promptly provide them with qualified diagnostics, observation by a psychologist or medical assistance.

To determine whether a person is schizophrenic, you need to know how schizophrenia manifests itself. But there is one nuance here. Most of the symptoms of this disease are significantly enhanced behaviors of healthy people. After all, every person has anxiety or aggression. In a healthy person, these types of behavior are normal. In a schizophrenic they either go beyond the norm, that is, they have pathological nature, or manifest themselves inadequately, not corresponding to the situation.

It is important to understand that schizophrenia is a diagnosis, not a definition. strange people. Therefore, in no case should you take responsibility by calling a person schizophrenic. Only a doctor can determine this. A person incompetent in this matter can only assume the presence of a disease and recommend visiting a specialist.

To know how a person suffering from schizophrenia differs from healthy people, it is necessary to determine the main signs of schizophrenia in adults and children. Since an accurate diagnosis cannot be made through visual contact with a person, attention should be paid to the most striking manifestations of the disease.

Main manifestations of schizophrenia

One of the main manifestations of schizophrenia is the presence of hallucinations in a person. They can be not only visual, but also auditory. Moreover, the second option is much more common. Patients often hear voices or dialogues in their heads. Usually they are illogical and can push a person to commit rash and non-standard actions.

When such a symptom appears, schizophrenics are usually unaware of the true nature of these voices. They believe that aliens or deities are talking to them, for example. They are confident in the correctness of all those actions that are imposed on them, even if it is jumping from a roof, etc.

Hallucinations in schizophrenia may also be accompanied by absurd and confused thoughts, called delusions. It represents the presence of illogical statements in which the schizophrenic sees clearly formulated thoughts. Sometimes such delusions can be of a paranoid nature. In this case, the patient feels that he is being persecuted, that they want to kill him or take him to some world he himself has imagined.

Another version of delusion may be exalting oneself or someone from the environment. A schizophrenic may talk enthusiastically about being a messenger who will save the world, or secret agent from another planet. All these stories will be intrusive, and if people around them reveal a lack of trust in these ideas, the patient may show strong aggression.

In addition, delusion can manifest itself in the form of jealousy. Having this symptom, a schizophrenic will be pathologically jealous of his partner. He will confidently talk about his significant other’s love affairs with a neighbor, a janitor, a salesman at a nearby store, etc. It is often impossible to convince such a person otherwise.

A symptom of schizophrenia can also be the identification of a hyper-significant personality by a person suffering from this disease. She may not only be a family member or acquaintance. It could be stranger, whom the schizophrenic will consider his master, mentor. He will be ready to unquestioningly carry out his instructions, believing in their righteousness. Because of this, the patient can become very vulnerable and fall under the influence of others.

All these symptoms characterize the most complex and profound form of the disease. Their manifestation may indicate a high percentage of probability of a person having the disease. But there are other types of schizophrenia, which differ in other signs and symptoms. They usually appear less intensely. Thus, in the first stage of schizophrenia, patients are often characterized by inappropriate behavior without visible disorders of consciousness.

Peculiarities of behavior of schizophrenics

To the main behavioral features of people suffering mild form schizophrenia include the following:

apathy towards people around you and work activity;
isolation and reluctance to communicate;
sudden and unreasonable outbursts of aggression;
catatonia.

This list is far from complete, since schizophrenia has many more behavioral changes. However, many of them border so much on the norm that it is impossible to identify pathological character almost impossible.

One of the most striking manifestations of schizophrenia is apathy. It can affect absolutely all areas of a person’s life. A person may become indifferent to communicating with other people, lose interest in activities that he was previously passionate about, and give up work or study. At the same time, a person does not feel the need to communicate with the outside world, he withdraws into himself and is ready to be completely alone for days. This state seems comfortable to him.

Vivid signs of schizophrenia

Aggression may also be a sign of schizophrenia. Moreover, it is usually spontaneous and does not depend in any way on the situation in which the patient is. Such aggression is not controlled by a schizophrenic. In this state, he can easily harm both himself and others.

Subsequently, he may not even remember what happened to him. In order to somehow explain these actions to themselves, schizophrenics give them a defensive character. They believe that this is the only way they can protect themselves from external threats. Moreover, these threats can sometimes be absurd. The patient may believe that some object or even color is causing him harm. He will avoid him in every possible way and be afraid of meeting him, considering it a mortal threat.

The catatonic state as a manifestation of schizophrenia is movement disorder. It may be characterized by continuous movements that may develop into obsessive-compulsive disorder. Having this symptom, the patient constantly makes some movements, which are often meaningless. He may walk in circles around the room, fingering beads, or washing his hands.

Another option is catatonic stupor. In this case, the schizophrenic freezes in some position, which can be completely uncomfortable and unnatural. The patient can remain in this position for several hours without responding to calls to him. Of course, this condition can also be a consequence of stress, but if it is systematic, then we can speak with great confidence about the presence of schizophrenia. This symptom answers the question of how to recognize schizophrenia.

All these manifestations and symptoms enable anyone to understand how to recognize a schizophrenic among healthy people. However, they are not the last resort for making a diagnosis. They can only indicate the presence of some mental illness, including schizophrenia, and become a prerequisite for visiting a psychiatrist or psychologist.

At the first manifestations of these symptoms in loved one You should immediately consult a doctor for advice.

You cannot delay with this issue, as you can aggravate the condition when the first stage of schizophrenia develops into an incurable pathology.

Schizophrenia is such a multifaceted disease in its manifestations that recognizing it in time can sometimes be quite difficult. Before the first obvious signs the disease can slowly develop over the years, and some oddities manifested in a person’s behavior are mistaken by many for a spoiled character or teenage changes. At the same time, having noticed such oddities, people often, instead of turning to a psychologist or psychiatrist, run to their grandmothers or traditional healers remove damage, roll out eggs, buy “magic” herbs, etc. Such actions only lead to a worsening of the patient’s condition and a delay in professional therapy. But exactly early diagnosis schizophrenia and timely treatment allows you to significantly improve the prognosis of the disease and get a high chance of full recovery. What signs allow us to suspect the approach of the disease and identify a tendency to schizophrenia?

Signs of schizophrenic disorder in the pre-morbid stage

Schizophrenia is endogenous disease and is associated with biochemical disorders of the brain. And pathological processes in the brain cannot but affect a person’s behavior and thinking. During childhood or adolescence, a person who may later develop schizophrenia does not stand out much from other people. However, some signs are still worth paying attention to. Such children are usually a little withdrawn and may experience learning difficulties. Behind them you can notice some oddities in behavior, for example, too frequent washing hands, unusual hobbies, coldness towards animals. Of course, the fact that a child is lagging behind in school and behaves withdrawn does not mean that he will necessarily suffer from schizophrenia in the future. It’s just that such a child or teenager should be monitored more carefully. It would also be a good idea to consult with a child psychologist.

Incubation period of the disease

As it gets worse pathological processes brain in schizophrenia, changes in the psyche and thinking become more pronounced. The incubation (prodromal) stage of the disease lasts on average about three years. Relatives do not always pay attention to gradually increasing oddities in the patient’s behavior, especially if this coincides with adolescence. Signs of the disease at this stage, which make it possible to understand whether a person has schizophrenia, may be as follows:

strange behavioral reactions;
desire for solitude, decreased initiative and energy level;
changes in handwriting (for example, handwriting may become illegible or the slant of letters in handwriting may change);
change in personality traits (a diligent and punctual teenager suddenly becomes absent-minded and careless);
deterioration of creative, educational or working abilities;
episodic simple hallucinatory or illusory manifestations;
new extremely valuable hobbies, for example, philosophy, mysticism, religious ideas.

Graphologists believe that it is possible to understand whether there is a predisposition to schizophrenia by looking at a person’s handwriting.

Handwriting can say a lot about personality and thinking. However, illegible and intermittent handwriting alone does not indicate schizophrenia; there must be others. characteristic manifestations diseases. If you begin to notice changes in handwriting or other signs in yourself or a loved one, you should consult a psychiatrist as soon as possible.

Self-diagnosis

Diagnosis of schizophrenia is difficult task even for experienced specialists. What can we say about trying to find out about the presence of such complex disease on one's own. An accurate diagnosis, determining the form of the disorder, can be made only after a series of examinations, differential diagnosis and conversation with a doctor. However, people often mean negative attitude to psychiatry and stereotypical beliefs, they are afraid to contact a psychiatrist, even if they discover warning signs. Therefore, many are interested in how you can identify schizophrenia in yourself without the help of a psychiatrist? You can figure out if you have cause for concern about schizophrenia with some self-testing techniques.

To get started, try the following statements for yourself:

It’s difficult for me to remember recent events, but I remember clearly what happened a long time ago;
I get bored from most conversations and I’m not interested in making new acquaintances;
I sometimes find it difficult to carry out daily duties;
sometimes I have thoughts that I am acting against my will;
It can be difficult for me to forget even minor grievances;
I often can’t bring myself to leave the house for days;
I am sometimes attacked by stupor or sudden excitement with aggression;
My thoughts are sometimes foggy and confused;
I am confident that I have unique abilities;
those around me are trying to control my feelings and thoughts;
I’m not interested in anything, and I don’t want to do anything;
I feel that my family is under threat;
for me my main adviser inner voice, I always consult with him;
I am annoyed by close people for unknown reasons;
I sometimes notice in myself a discrepancy between my expressed emotions and the surrounding environment and the emotions of other people;
I often discover in myself an unreasonable feeling of fear;
It’s difficult for me to show feelings of tenderness and love; I’m often self-absorbed.

Think about how true it would be for you to hear the following statements addressed to you from loved ones:

you are not at all concerned about the suffering of other people or animals, your face does not reflect a feeling of compassion;
you don’t look your interlocutor in the eyes;
you sometimes talk out loud to yourself;
you most like to spend time alone with yourself, avoid crowded places and attention from others;
you hear something that is not really there, and what those around you do not hear;
you began to speak indistinctly (stutter, lisp);
your writing has become worse, your handwriting is somehow strange and illegible;
you are considered a little eccentric, and strange expressions are noticed on your face;
you talk to inanimate objects as if they were alive;
you sometimes laugh or cry for no reason;
you spend quite a lot of time on meaningless activities (you lie for hours, staring at the ceiling).

How to evaluate such testing? The more of the above statements apply to you, the higher your tendency and predisposition to schizophrenia and the more important it is for you to visit a specialist. Note that it is inclination! Because, even if absolutely all statements are identical to you, this does not mean that you have a schizophrenic disorder. Only a psychiatrist can make a diagnosis.

You can also find out if you have signs of schizophrenia by using visual test“Chaplin's Mask”, created by British neuropsychologist R. Gregory. Experience in observing patients shows that a characteristic feature of schizophrenia is a person’s immunity to visual illusions.

While taking this test, don't take your eyes off the picture. If everything is in order with your psyche, you will notice the optical illusion.

Diagnostics and MSE

The process of diagnosis and MSE (medical and social examination) for schizophrenia can take quite a long time, since the manifestations of the disease are very diverse. Differential diagnosis allows you to exclude mental, somatic and neurological pathologies which have symptoms similar to schizophrenia. However, put accurate diagnosis It is not always possible immediately even after differential diagnosis. How it goes diagnostic process? To begin with, the psychiatrist assesses the patient’s condition during a conversation. It reveals productive and negative symptoms, as well as the degree of cognitive impairment. Various tests are often used. For example, one can fairly accurately predict schizophrenia based on eye movements.

A person with this pathology cannot smoothly follow a slowly moving object with his eyes. Specific eye movements in schizophrenics are also observed when freely viewing pictures. An experienced doctor is able to recognize signs of pathology in eye movements. It is also difficult for such people to keep their eyes still for a long time and fix their gaze on something. After the conversation, a series of examinations are carried out that allow us to assess the characteristics of the central nervous system and identify concomitant diseases, and endocrine disruptions. Studies such as EEG, MRI, TDS (special ultrasound scanning cerebral vessels) allow more accurate differential diagnosis, assess the severity of schizophrenia and select the most effective medications. MRI for schizophrenia is one of the effective ways solving the problem - how to recognize schizophrenia even before its obvious signs appear and a person’s well-being deteriorates. It has been proven that changes in brain structures begin long before the symptoms of schizophrenia develop.

During the treatment process, at each stage of remission, an MSE of the patient is performed. If the exacerbation is protracted, MSE can be performed during the attack. During MSE, the duration and clinical form schizophrenia, dynamics and nature of negative disorders, type and characteristics mental disorders. Also during the MSA process, it is important to assess how critical the patient is of his condition. During MSE, the stage of the disease, the nature of the leading syndrome and the quality of remissions are assessed. All this is necessary to determine the patient’s disability group based on the results of the MSA. The first group of disability is most often caused by continuous-current malignant form a disease that develops early and causes a rapid increase in negative disorders.

In everyday life, schizophrenics are people who are unbalanced or simply scandalous. In fact, this disease affects a certain type of people who have nothing in common with brawlers

Schizophrenia is still considered one of the most mysterious mental illnesses that has accompanied humanity throughout its history. Until now, scientists and doctors cannot answer the question of what is its cause.

It is only clear that the disease develops exclusively under the influence internal factors. It is completely wrong to look for its causes in the misfortunes that befall a person - the death of loved ones, unsuccessful love, in mental overload and stress.

Scientists have suggested that important role Brain biochemistry plays a role in the development of the disease. For example, a lack of dopamine, the hormone of pleasure, which leads to self-absorption, gloominess, “insensitivity” towards others, and sometimes to extravagance in behavior.

Heredity plays a significant role in the development of schizophrenia. But even here everything is unclear: it is known that even those parents, both of whom are sick, most often give birth to healthy children.

Another mystery: among those who suffered from clinical schizophrenia, many outstanding people. There are scientists, artists, writers, and other artists here. Why are they affected by this disease? It can be assumed that a highly developed psyche has increased fragility: this is the price to pay for giftedness and talent.

Down the stairs"

Genuine schizophrenia is most often invisible to the untrained eye. It can develop slowly, gradually destroying a person, but it can manifest itself abruptly, in a matter of weeks, or even in a matter of days, making a person unrecognizable. Such sudden attack the disease is called "fur coat". This term comes from German word, meaning shift. In this state, the patient is capable of the most desperate, but at the same time senseless acts. If you try to sort things out with him, the person will not even deny what he did, but he will not condescend to explain. And this is the result of a painful perception of the world: a patient with schizophrenia has lost the ability to perceive it holistically. No wonder “schizophrenia” means “split of the mind.”

After each painful attack, a person changes more and more, as if going down some kind of ladder.

A characteristic symptom of schizophrenia can be considered a painful disorder such as pseudohallucinations. “True” hallucinations are practically indistinguishable from real sensations. But pseudohallucinations are never mixed with other sensations. These hallucinations include so-called voices in the head. From the outside, you can notice that a sick person seems to be listening to something, arguing with someone, plugging his ears with his fingers or cotton wool.

The patients themselves, however, prefer not to talk about it. There is a medical joke: when the doctor asks “Can you hear voices?” the patient immediately gives an affirmative answer, then this is a malingerer.

Delirium delirium - discord

Another important sign schizophrenia - delusional states. There may be delusions of persecution, invention, reformation, special significance. A sick man can claim that his wife hates him because her slippers in the hallway were pointing different sides... Or that you wish him harm because you wore a gray suit.

Especially often negative emotions concern people close to him - and the closer and the person is more important the person they are directed at, the stronger they are. At the same time, the patient is deeply convinced of the truth of his ideas and it is never possible to refute them from the standpoint of logic.

The so-called reactive psychosis, which can have very similar manifestations, should not be confused with schizophrenia. This disorder can manifest itself as a relapse into childhood, when, for example, an experienced military man, after an artillery shelling, begins to feel like a child whose father sent him to the store to buy potatoes. And now the person is permeated with anxiety, he is afraid to return home because he could not buy anything... However, there is some logic in such delusional constructions: before the enemy’s shelling, a person is as defenseless as a child before a stern father. Similar fears play protective role: they seem to “turn you off” from a life-threatening situation, “forcing” you to fear something that is less scary than reality. Reactive psychosis ends as abruptly as it began.

Similar to schizophrenia and endogenous depression, when the patient’s mood

sharply reduced, thoughts are slow, may be present discomfort, like a stone in the body. Causes endogenous depression are also unclear. However, they have learned to correct it with the help of medications.

Hard way

Treatment for schizophrenia today, unfortunately, is not very successful: a person with such a diagnosis is forced to spend his entire life on special drugs. Their cancellation can cause a further “slide” down the ladder of the disease.

It is also necessary regular treatment in a hospital, when medications are taken under the supervision of a psychiatrist, which in itself presents a certain difficulty, because such patients most often consider themselves healthy and it is difficult to persuade them to go to the hospital. It is very difficult for the relatives of such a patient. It is advisable that they use the help of a psychotherapist to help them withstand particularly critical situations.

To find out about your predisposition to this disease, doctors recommend carefully analyzing your behavior. The first signs of schizophrenia are easy to identify. The main thing is not to confuse them with symptoms of other diseases.

People prone to mental disorder, is distinguished by a number of behavioral factors.

1. A sign of schizophrenia is a changed manner of communication. If a person talks exclusively in short phrases, often remains silent or has difficulty finding words, which means he mental condition not okay.

2. If you find it increasingly difficult to look into the eyes of your interlocutors, and you look away with relief, just in case, make an appointment with a specialist.

3. Do you no longer enjoy your previous hobbies? Can't concentrate and finish what you started? Perhaps it's not just laziness and fatigue...

4. Do you have a lot of important thoughts in your head that you can’t think through to the end? Try switching gears and getting some rest. If it doesn't help, you can start sounding the alarm.

It should be remembered that schizophrenia is a sluggish disease. The interval between detection of the disease and the onset of its severe stage may not be a year or two.

The following signs of mental illness characterize its more serious form:

1. Hallucinations. The patient talks to non-existent characters, talks about things that did not happen, etc.

2. Mania of persecution (specification of one’s enemies).

3. Untidy. A person suffering from schizophrenia becomes deeply indifferent to what his apartment and himself look like.

4. Abrupt change moods.

If you nevertheless discover the first signs of schizophrenia, you should not be upset. With proper treatment, this disease has long periods of remission. To delay as much as possible severe form diseases must be avoided stressful situations and don't take drugs.

16.10.2017 26.01.2019 Alexander Firtsev

One of the most current issues at psychological counseling and even more so when conducting psycho- and hypnotherapy is the identification of schizophrenic patients on early stages treatment. It is clear that in the course of work, a psychologist cannot and should not work with patients with schizophrenic pathology; psychiatrists specialize in this.

If he takes on this case, he endangers not only his client's health, but also his own. A patient with an open delusional plot, with hallucinosis, with some other conspicuous manifestations of schizophrenia, which are written about in literature, mainly fiction, is quite easy to identify. But in fact, schizophrenia is diagnosed not by such obvious, striking symptoms, but by completely different ones. And the identification of precisely the hidden, simple form of schizophrenia in initial appointment, especially the neurosis-like form, which is often very similar to neurosis, is priority psychologist.

It should be noted that the criteria given in this article can act as a support in diagnosing a disease only when they are used together, but not separately. In addition, the psychologist should carefully study the symptoms and make sure that the patient has psychotic symptoms and not neurotic ones.

So, what are the criteria for diagnosing schizophrenia?

Firstly, it is ambivalence and ambitendence, that is, the ability to simultaneously experience opposite emotions in relation to one object (person or phenomenon).

Secondly, this is a disorder of associative activity, thinking, isolation of the patient, fear of people. Also apathy and abulia. Abulia and apathy are most easily translated into non-medical language as a kind of universal laziness: the patient finds it difficult to do basic things, and to find an excuse for his inactivity, he sometimes comes up with excuses that are quite funny, in the eyes of a healthy person. For example: “I’m not going to work today because it’s raining” - this is a classic example of the thinking of such a patient. At the same time, it is important for a psychologist to be able to distinguish such “laziness” from similar symptoms neurotic depression or .

Now let's move on to practice, how to apply this knowledge at the initial appointment. Since the patient’s thinking is upset and he thinks illogically, a very important sign is his lack of punctuality, or rather his attitude towards being late or arriving early.

The first sign: endogenous patients usually arrive for appointments at the wrong time, often either late or delayed; usually enter through the back door rather than the front door of the hospital. In addition, they do not seem to notice their absent-mindedness, for example, if a person who is simply not punctual is late from session to session, but at the same time will wildly apologize, look for excuses for himself, or simply be embarrassed, then a schizophrenic does not do this, he simply does not notice his absent-mindedness .

The second point to pay attention to is that a schizophrenic may not make eye contact at all. This is otherwise called ocular autism, when the patient does not look the doctor in the eyes, and this is one of the signs of schizophrenia. It is absolutely clear that hiding your eyes when telling something shameful or something you want to hide is a normal human reaction. But if during the entire session the patient avoids the specialist’s gaze, then this is already a reason for a deeper diagnosis, in which it is important to make sure that the symptom is not the result deep feeling guilt or shame.

The third point is the patient’s clothing, or rather, its illogicality: mixing styles, wearing old, shabby clothes when the person has the opportunity to purchase normal, new ones. That is, some minor inconsistencies that cannot be explained by direct logic.

The next thing to pay attention to is how the patient moves. Patients with schizophrenia have some cataleptic movements - they freeze, take (uncomfortable) poses in a chair, which healthy man never accepts. But the main oddity is that patients, being in often uncomfortable position, do not reflect either anxiety, or a state of comfort, or demonstrativeness with their pose.

Fourth: inconsistency of speech. To detect this sign in a patient, sufficient training and the skill to pay attention to some non-logical or paralogical or near-logical constructions in speech are required. This is determined in the following way: the patient is sometimes asked a fairly simple, specific question, and the patient answers either around the question or not to it, or answers the question first, and then goes into philosophizing that does not relate to the topic being asked, does not relate to the patient’s current complaints. This was one of the ways to identify the illogicality of speech. This check should be carried out several times, because it happens that the patient simply does not understand the question, although the question should be formulated as precisely as possible. An example of a question: “how many grades in school have you completed?”

The next point: the discrepancy between the strength of the psychological trauma and the magnitude of the complaint. Often such patients of the neurotic type view their psychotrauma as the cause of their illness, despite the fact that schizophrenia is not a consequence of psychotrauma. And when we see much more psychopathic behavior in a patient than the psychotraumas he named suggest, we should continue the diagnosis in more depth and, if necessary, recommend an appointment with a psychiatrist.

The biggest mistake in diagnosing a schizophrenic happens when the one who diagnoses him begins to sympathize with him. How this can be: due to the autism and apathetic symptoms of the patient, he often loses his job, but for the loss of each job he has some explanations, for example: conflicts with his superiors, the work has become uninteresting, he no longer feels inspired, and so on etc. It is important here to correlate the reality of the story with what the patient is telling.

As an example: a person who graduated from college, having a good academic record, cannot find a job for a number of years and is supported by his parents, already arouses certain suspicions.

Also requires special attention emotional sphere sick. Apathy, in other words, the inability to experience emotions, is present only in late stages development of the schizophrenic process. On early stages rudeness and emotional inadequacy arise, it seems that the patient is talking about himself as if a bad actor were portraying the patient. That is, we do not see small emotions, just as we do not see those little things, those antics, that emotional game, which the average patient or client has.

Perhaps these were all the factors that we wanted to tell you about. Once again, as a reminder, I would like to emphasize: none of the above signs individually is considered an indicator of schizophrenia; they can only be such in combination.

If you suspect this diagnosis in a patient, then in order to make sure that you are not dealing with deep or shallow neurosis, or depression, which is disguised as apathetic-abulsic symptoms, it is advisable to have the skills of basic psychodiagnostics.

The clearest tests for diagnosing schizophrenic disorders and diseases are: exclusion test, classification test. Pictograms in Khersonsky’s modification and the Luscher color test in Sobchik’s modification have a supporting role.