What are the major features of schizophrenia?

Schizophrenia (DSM-5): 2+ symptoms present for significant portion of 1 month (or less if treated successfully): (1) Delusions — fixed false beliefs (persecutory, grandiose, somatic, religious, referential — believing TV is talking to you); (2) Hallucinations — false perceptions in any sense; auditory hallucinations (hearing voices) most common; (3) Disorganized speech — derailment, tangentiality, incoherence; (4) Grossly disorganized or catatonic behavior; (5) Negative symptoms — diminished emotional expression, alogia (poverty of speech), avolition (lack of motivation), anhedonia (inability to feel pleasure), asociality. At least one must be hallucinations, delusions, or disorganized speech. Significant impairment in work, relationships, self-care. Continuous signs for 6+ months. Typically: prodromal phase with subtle changes, active phase with full symptoms, residual phase with continuing negative symptoms. Treatment: antipsychotic medications — first-generation (typical) like haloperidol, chlorpromazine; second-generation (atypical) like risperidone, olanzapine, quetiapine, aripiprazole, clozapine. Atypicals are first-line — fewer extrapyramidal symptoms (EPS) but more metabolic side effects (weight gain, diabetes, lipid changes). Side effects to monitor: EPS (tremor, rigidity, akathisia, tardive dyskinesia, neuroleptic malignant syndrome), metabolic changes, anticholinergic effects, sedation. Clozapine — most effective but requires WBC monitoring due to agranulocytosis risk. Psychosocial interventions: psychotherapy, family education, supported employment, social skills training, assertive community treatment. Nursing care: therapeutic communication, reality orientation when needed without arguing about delusions, monitor for medication adherence and side effects, recognize relapse early.