Schizophrenia and Psychosis: Hallucinations and Delusions
Psychosis symptoms include hallucinations and delusions and are often the way in which schizophrenia is first detected. Schizophrenia contains more than just psychotic symptoms, but those are the ones that often stand out to those around the schizophrenic. Delusions and hallucinations are considered to be “positive symptoms” in schizophrenia (what are the positive and negative symptoms of schizophrenia?).
Schizophrenia is classified in the DSM (Diagnostic and Statistical Manual of Mental Disorders) as a psychotic mental illness, indicating that its primary symptoms are those of psychosis. Other psychotic disorders include:
- Brief Psychotic Disorder
- Delusional Disorder
- Schizoaffective Disorder
- Shared Psychotic Disorder
(See the DSM schizophrenia diagnostic criteria)
Psychosis Symptoms – Hallucinations and Delusions
Psychosis is made up of hallucinations and delusions. Hallucinations consist of perceiving things that aren’t there. Many people have hallucinations for a long time before anyone notices anything is wrong. Hallucinations can seem very real to the person with schizophrenia and he may not have the insight to know they aren’t real.
Hallucinations in schizophrenia are often auditory but may also be:1
- Visual – seeing things that aren’t there
- Olfactory – smelling things that aren’t there
- Tactile – feeling things that aren’t there
Hearing voices is common in schizophrenia. There may be multiple voices talking to each other or voices talking to the person with schizophrenia. There may also be a voice that consists of a running commentary on what the person with schizophrenia is doing. Hearing voices in schizophrenia can be very distressing, as the voices can order the person to do things or warn the person of dangers that don’t exist.
Other examples of hallucinations in schizophrenia include:
- Seeing people that aren’t there
- Seeing objects that aren’t there
- Smelling scents that no one else smells
- Feeling nonexistent fingers on the skin
- Feelings nonexistent bugs crawling on the skin
What are Delusions?
Delusions are false beliefs that do not change and significantly affect a person’s ability to function. Delusional schizophrenic beliefs often occur even when there is no evidence of them or when there is evidence to the contrary.2 These beliefs are not cultural or religious in nature.
Examples of common types of delusions include:3
- Believing you are someone famous like Jesus Christ or Cleopatra (grandiose delusions)
- Believing that someone is out to hurt you or spy on you when there is no evidence of this (delusion of persecution)
- Believing your thoughts are controlled by others, such as by aliens, or that others are inserting thoughts into your head (thought insertion, withdrawal, control, or broadcasting)
- Believing things around you, such as newspapers and books, are about you (delusions of reference)
- Believing that someone else, normally someone famous, is romantically involved or attracted to you (erotomanic delusions)
- Believing you have a medical condition or flaw (somatic delusion)
Treatment of Delusions and Hallucinations
Psychosis symptoms, delusions and hallucinations, are typically treated with antipsychotic medication, also known as neuroleptic medication. Medication is often very effective at removing or lessening the hallucinations and delusions in schizophrenia but the symptoms of psychosis may return if the person stops taking their medication.
Last Updated: 14 July 2016
Reviewed by Harry Croft, MD