Q.While speaking in public the patient changes topics frequently, is this a positive or a negative symptom of schizophrenia? Describe the other symptoms of schizophrenia.

Frequently changing topics while speaking is a formal thought disorder, in which thinking rapidly shifts from one topic to another so that the normal structure of thought becomes muddled and illogical (loosening of associations or derailment). Because it is a 'pathological excess' or bizarre addition to behaviour, it is a positive symptom of schizophrenia, not a negative one.

The other symptoms fall into three groups. Positive symptoms (excesses): delusions (of persecution, reference, grandeur, control), formal thought disorders, hallucinations (auditory being most common), and inappropriate affect. Negative symptoms (deficits): poverty of speech (alogia), blunted and flat affect, loss of volition (avolition), and social withdrawal. Psychomotor symptoms: odd grimaces and gestures, reduced spontaneous movement, and extrem …

Is topic-switching positive or negative?

Speaking in public and frequently changing topics is an example of a formal thought disorder, which makes communication extremely difficult. It includes rapidly shifting from one topic to another so that the normal structure of thinking becomes muddled and illogical (loosening of associations or derailment). Positive symptoms are 'pathological excesses' or 'bizarre additions' to a person's behaviour, and disorganised thinking and speech are among them — therefore this is a positive symptom, not a negative one.

Schizophrenia and its three symptom groups

Schizophrenia is a group of psychotic disorders in which personal, social and occupational functioning deteriorate as a result of disturbed thought processes, strange perceptions, unusual emotional states and motor abnormalities. Its symptoms are grouped into positive, negative and psychomotor symptoms.

1. Positive symptoms (excesses of thought, emotion and behaviour)

• Delusions — false beliefs firmly held on inadequate grounds. Types include delusions of persecution (most common — being plotted against, spied on, threatened), delusions of reference (attaching special personal meaning to others' actions or to objects/events), delusions of grandeur (believing oneself specially empowered), and delusions of control (believing one's feelings, thoughts and actions are controlled by others).
• Formal thought disorders — loosening of associations/derailment, coining new words (neologisms), and inappropriate repetition of the same thoughts (perseveration).
• Hallucinations — perceptions in the absence of external stimuli. Auditory hallucinations are most common (second-person and third-person); others are tactile, somatic, visual, gustatory and olfactory.
• Inappropriate affect — emotions unsuited to the situation.

2. Negative symptoms (pathological deficits)

• Poverty of speech (alogia) — reduction in speech and its content.
• Blunted affect (showing less emotion) and flat affect (showing no emotion at all).
• Loss of volition (avolition) — apathy and an inability to start or complete a course of action; social withdrawal.

3. Psychomotor symptoms …