Detailed information about psychotic episodes, hallucinations, delusions, and early intervention.
Derailment, sometimes called loose associations, is when ideas slip off track within a single sentence — one of the core features of formal thought disorder.
DelusionsSomatic delusions centre on the body — its shape, its insides, or what is supposedly inhabiting it. They are often highly distressing and frequently misdiagnosed.
SymptomsAlogia is the negative symptom that quietly affects conversation — fewer words, less elaboration, longer pauses. It is rarely about not having anything to say.
HallucinationsOlfactory hallucinations — phantom smells with no source — are an uncommon but real symptom in schizophrenia, and they have a long differential diagnosis worth taking seriously.
HallucinationsSmelling something that nobody else can smell is unsettling. In most cases the cause is neurological or ENT-related, but olfactory hallucinations can also occur in schizophrenia.
PsychosisSchizoaffective disorder sits in the territory between schizophrenia and bipolar or depressive illness. The diagnosis is precise — and the treatment approach reflects both halves.
Rare presentationsKurt Schneider's first-rank symptoms once defined schizophrenia almost on their own. Modern diagnostic systems have stepped back from that idea — but the symptoms themselves still matter.
PsychosisA psychotic episode is a period when a person's brain produces experiences that aren't shared by the people around them. Understanding it from the inside changes how you respond.
DelusionsErotomanic delusions — the firm belief that another person, often someone unattainable, is secretly in love with you — are uncommon but cause real distress on both sides.
SymptomsAvolition is the absence of the internal push that normally gets people moving. It's a real neurological symptom, not a character flaw — and there are things that help.
Negative symptomsAttention deficits are one of the most common cognitive symptoms of schizophrenia — and one of the strongest predictors of how someone will function day to day.
HallucinationsTasting something that isn't there is the rarest type of hallucination. Causes range from epilepsy to medication side effects, with schizophrenia accounting for a small minority.
Thought disorderNeologisms are newly invented words or familiar words used in idiosyncratic ways. They are a less common but distinctive feature of formal thought disorder.
HallucinationsTouch hallucinations — feeling pressure, crawling, heat, or being touched without a real source — are uncommon but distressing, with several possible causes worth distinguishing.
DelusionsErotomania, also called de Clérambault syndrome, is a delusion that another person — frequently a stranger or public figure — is secretly in love with the patient. It is rare but can drive serious behaviour.
Rare presentationsSimple schizophrenia described slow, insidious negative symptoms without dramatic psychosis. DSM dropped it; ICD-10 kept it; ICD-11 has now retired it too. The clinical picture remains.
PsychosisSchizophreniform disorder is the diagnostic label for psychosis lasting one to six months. It often, but not always, becomes schizophrenia.
DelusionsDelusions of reference are the eerie experience of feeling that ordinary events — a song lyric, a stranger's glance — carry hidden personal meaning meant just for you.
SymptomsFlat affect is reduced outward expression of emotion — but research shows the inner emotional experience is often largely intact. The disconnect is in expression, not in feeling.
DifferentialThree psychotic diagnoses, three time frames. The DSM uses the duration of symptoms to distinguish them — and treatment changes as the diagnosis evolves.
Thought disorderThought blocking is the sudden, abrupt interruption of a train of thought. The speaker stops mid-sentence and often cannot pick the thread back up.
HallucinationsPhantom tastes — bitter, metallic, foul — are an uncommon but recognised hallucination in schizophrenia, often appearing alongside olfactory experiences and a long differential diagnosis.
HallucinationsHearing music that nobody else can hear is more common than people think — and far more often a sign of hearing loss than psychiatric illness.
DelusionsThought broadcasting, insertion, and withdrawal are among the most disorienting experiences in psychosis — the felt sense that the boundary of one's own mind has been breached.
SymptomsThe DSM-5 removed the paranoid subtype of schizophrenia in 2013. The clinical pattern it described still occurs in many people — and understanding it helps treatment.
PsychosisPostpartum psychosis is rare but severe — and unlike postpartum depression, it usually requires immediate hospitalisation. Early recognition saves lives.
Negative symptomsWorking memory — the ability to hold and manipulate information for a few seconds — is one of the most consistently affected cognitive functions in schizophrenia.
DelusionsThought withdrawal is one of the more disorienting experiences of psychosis — the felt sense that a thought is being pulled out of one's head, sometimes mid-sentence. It is a classic first-rank symptom.
HallucinationsHallucinations at the edge of sleep are common in healthy people and usually mean nothing. Knowing how they differ from the hallucinations of psychosis prevents a lot of unnecessary alarm.
Rare presentationsDissociation and psychosis can look like each other — voices, perceptual shifts, lost time. They are distinct conditions, but they overlap more often than older textbooks suggested.