Schizophrenia Primer 1 of 3: Positive Symptoms of Schizophrenia

Learn more about how positive symptoms impact patients.

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Understanding positive symptoms of schizophrenia and their impact on daily living

The positive signs of schizophrenia, termed “positive symptoms,” are linked to malfunctions in the brain’s mesolimbic pathway.¹ People with positive symptoms often experience delusions, hallucinations, exaggerated or distorted language and communication, disorganized speech and behavior, catatonic behavior, and agitation.¹ Positive symptoms are associated with a lower quality of life, as affected individuals may live in isolation and poor housing, with limited education and poor social and vocational skills.² Positive symptoms are often the most recognized symptoms of schizophrenia and are a major target of pharmacotherapeutic treatments for schizophrenia.¹ 

Challenges and advances in treating positive symptoms of schizophrenia

There are many approved pharmacotherapeutic options for the treatment of positive symptoms.¹ These options include antipsychotics that target dopamine D2 receptors.^1,3 Despite the availability of these pharmacotherapies, unmet needs persist in treating positive symptoms, including treatment-resistant schizophrenia (nonresponse to ≥2 sequential trials of antipsychotics at sufficient dose, duration, and adherence), tolerability, and medication adherence.^4–7 Atypical antipsychotics that combine D2 antagonism with serotonin (5HT) 2A antagonism have become available and generally offer fewer side effects.^1,3 While there have been many pharmacotherapeutic developments for the positive signs of schizophrenia, challenges in care exist as >2 out of 3 people with psychosis do not receive specialist mental health care worldwide.⁸ Continued research and innovation are crucial to address these challenges and unmet needs and improve outcomes for people with positive symptoms of schizophrenia.³

Explore our resource section to find additional research and practical information.

Further reading

• Ruiz-Castañeda P, et al. Positive symptoms of schizophrenia and their relationship with cognitive and emotional executive functions. Cogn Res Princ Implic 2022;7:78.
  This study examines the specific deficits in cognitive and socioemotional impaired executive function in patients with schizophrenia with a predominance of positive symptoms.
• Longden E, et al. The relationship between dissociation and symptoms of psychosis: A meta-analysis. Schizophr Bull 2020;46:1104–1113.
  A metanalysis quantifying the magnitude of association between all symptoms of psychosis and dissociative experiences.

Cite this article as Schizophrenia Primer 1 of 3: Positive Symptoms of Schizophrenia. Connecting Psychiatry. Published February 2025. Accessed [month day, year]. [URL]

SC-US-77222

SC-CRP-16786

November 2024