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Mental Health Information Centre - Southern Africa


Fred was a 21 year old sales representative, who had seemed to be making steady progress in his career for several years. After the past several months, however, management had noted a substantial decrease in his performance. When confronted about this, he admitted that his mind was no longer fully on his work. In particular, he felt that he had begun to enter a more spiritual realm. In fact, he even stated that at times he could hear and see beings from “beyond the other side”. Fred was referred to the company’s counsellor, who noted that he had difficulty concentrating well, that his logic seemed very unclear, and that he often appeared to lose touch with reality.

Fran was a 28 year old nursing assistant, who had become increasingly withdrawn at work. Although she managed to complete her duties, she was a loner who seemed to have no friends. People found her difficult to talk to, as she seemed to be rather unemotional – as though she didn’t really experience her feelings strongly. She also seemed to show little motivation in her career. Things might have gone on in this way for longer, had Fran not come to the Matron complaining that some of the other nurses were jealous of her, and had organized a vendetta against her. When asked for evidence of this, Fran stated that she simply knew these things.

Signs and Symptoms

“Positive” Symptoms

Hallucinations – abnormal sensory perceptions – for example, hearing voices or seeing people when no-one else is around.

Delusions – false beliefs based on abnormal reasoning – for example, the incorrect conviction that people are out “to get” one.

Disorganized speech or behavior – for example, talking very circumstantially or incoherently, behaving oddly with no clear plan or reason.

“Negative” Symptoms

Affective flattening – reduction in the range and intensity of emotional expression.

Alogia – impoverishment in thinking, for example, restricted amount of spontaneous speech, overly concrete or overly abstract speech. 

Avolition – inability to start and maintain goal-directed activities.

Myths and Facts


Schizophrenia involves a split personality, as in the Dr. Jeckyll/Mr. Hyde character.


Schizophrenia is a disorder of the brain, which leads to specific symptoms such as hallucinations and delusions.


Like the Dr. Jeckyll/Mr. Hyde character, people with schizophrenia are usually dangerous and violent.


Schizophrenia is an extremely distressing illness. Most people with this illness are not even noticed by society, but rather suffer in silence.


People who lose touch with reality (during hallucations and delusions) are “crazies” for whom nothing much can be done.


Hallucinations and delusions are usually the product of a brain disorder. Fortunately, effective treatments are now available for such conditions.


It is clear the schizophrenia involves specific brain chemicals and regions. Several factors appear to contribute to its onset, including genetic ones. However, ultimately much remains unknown about the exact causes of schizophrenia.

Best treatment

Specific medications are very useful in controlling the symptoms of schizophrenia. In recent years major advances have been made in this area, and several new agents are now available. In addition, it is important for family to educate themselves about schizophrenia so that they are best able to support the family member with schizophrenia.


Prognoses differ very much from individual to individual. Some people can experience a remarkable return to normal function. Others experience a chronic course with episodes of illness. Usually medication results in a substantial reduction in the symptoms of schizophrenia.

Download pdf for more information: Schizophrenia psychosis

Mental Health Topics

In partnership with:

University of Stellenbosch
South African Medical Research Council
University of Cape Town