I do not know much about schizophrenia. I have met two people who were schizophrenic who discussed their symptoms with me.
The young man was medicated but he was still too ill to work and lived off disability. The woman may also have been medicated and she also lived off disability. This is a typical outcome for this illness, sadly.
Her diagnosis was a true grab bag, and she had been diagnosed with everything in the book, including OCD and frequently Borderline Personality Disorder. I was not sure what her complete picture was, but in adolescence and early adulthood, she underwent what looked like a classic schizophrenic prodrome process. There’s nothing else that looks like that. Afterwards a lot of psychotic symptoms developed including visual hallucinations. Also she did not believe she was ill, which is typical of these folks.
I could not really see the Borderline PD. The problem with these schizophrenics is that the schizophrenic process is so complete and totalizing that it essentially swamps over all sorts of other or lesser symptoms.
The man also had an OCD process going on, and he denied his symptoms were caused by mental illness. He was also trying to hide symptoms from me, which they do sometimes after the illness goes on for a while. It’s not that they believe the symptoms are crazy – they think it is actually true that the man in the TV said, “It’s going to rain today” and that really is a secret message to them telling them to go to the store and buy a pack of cigarettes. Incidentally that is a common type of psychotic symptom and they are called delusions of reference and they are common in schizophrenia. I have someone close to me who had Bipolar 1 Disorder with prominent psychotic (schizophrenic-like) features who had symptoms exactly like that.
The thing is that even chronic psychotics are not stupid and are driven by the pleasure principle to avoid pain. Eventually these people often figure out that when they say certain things like that the CIA is after them, people tend to get alarmed, call the police and they get hospitalized. Being more rational than you would think, they learn to keep some of these symptoms to themselves if only to stay out of the hospital.
He had a lot more insight than a typical schizophrenic which may be due to the OCD, which would introduce a chronic doubting nature into the psychosis, which would be good for any psychosis, as they are based on hard belief. There are new theories about an illness called Schizo-obsessive Disorder which looked a lot like what this man had. Paranoia, Shneiderian symptoms, and a better prognosis are among the features. To give you an example of the Shneiderian features, for instance, this man heard his own thoughts spoken out loud in the exact same way as if you were to speak your thoughts out loud – how creepy! He was afraid to ride the buses as he feared that the others on the bus could hear his thoughts as he thought them as they sounded as loud and clear as if there were someone talking right next to you.