ICD-10 symptoms vs. SD intoxication

Examples of ICD-10 schizophrenia symptoms collected from reports of the intoxication of the sage salvia divinorum, called by the Mazatec Indians of Oaxaca hojas de la maria pastora 'leaves of the Virgin Mary, the Shepherdess':

(a) thought echo,

Excerpted from Usenet archives:

"what happened was i would go into this state where my body seemed to be talking to me...but not in the sense that it really had anything to say, actually it was just my thoughts echoing to themselves, but such that it gave the impression that the echo was really saying something...the echo which echoed off of my body..."


...thought insertion or withdrawal,

Excerpted from The Vaults of Erowid:

"Again, I was aware of entity contact. Both times the first stop was in a sort of anteroom, where I was being examined by what seemed like doctors or psychiatrists, who were curious but largely ambivalent about me. I found out that they were judging whether or not I was worthy. The first time I was here I was nervous, but not frightened. Above all, I didn’t want them to send me back again. A Word inserted itself into my consciousness, although it meant nothing to me. It could have been a name, or a powerful incantation. Whatever it was, the doctors granted me passage through the next door."


... and thought broadcasting

Excerpted from Usenet archives:

"Yeah same here. I had a strong sense that I somehow caused an infinite repetition of the terrifying moments i experienced, like a recording of my mindset being broadcast to everybody and everything forever..."


(b) delusions of control, influence, or passivity, clearly referred to body or limb movements or specific thoughts, actions, or sensations; delusional perception;

Excerpted from The Vaults of Erowid:

"I remember seeing (B), (J), and (M). They were clearly staring at me like I was nuts, therefore making me paranoid and projecting me into a worse state of mind. I had enough time to tell them to "get rid of the shit!!!", meaning the salvia, and to take the dog upstairs. Then both realities became completely unstable and were jumping back and forth so furiously, I was in complete submissiveness. Like I lost the battle of life or something so similarly equal. It was controlling me and had been the whole time without any concept of my part in the whole thing.

I was now back to sitting on my bed with my hand still down my throat trying to grab the black hole that was swallowing my exterior from my interior. I heard my sister (M) say "He’s gonna pop" which threw me back into new reality. I then believed I was in a hospital operating room, tied down, convulsing with my organs spewing from my mouth like some severely sick individual. The imagery was horrendous. I came to the "real" reality and found everyone looking at me in the most uncomfortable manner, like I had lost my mind completely. Or like I was a homeless puppy dog in need of help. I still can’t figure out what the look exactly was, but it did give me one of the worst feelings of my life. I then became completely paranoid, insisting that everyone stop staring at me and to not talk about the situation we had just experienced. I was frightened and unsure and most of all, felt like I was thrown down a rabbit hole that I wasn’t expecting."


(c)hallucinatory voices giving a running commentary on the patient's behaviour,

Excerpted from Usenet archives:

"...I was being pulled, very strongly, into 'something', and it was _worrying_. The radio changed - it was loudly and clearly talking about me, sounded like overhearing a walkie-talkie-talky communication between two coppers..."


...or discussing the patient among themselves,

Excerpted from The Vaults of Erowid:

'Unable to interpret what was happening I simply concluded that nothing could be happening (it’s easier), but just as I reached this decision, it suddenly dawned on me that Bart and Lisa Simpson were standing over me, looking down at me lying in the road, discussing my state, saying things like, "Look what he’s done!" and, "Now he’s gone and done it!"

What the…?

I felt so uncomfortable, raw and exposed, as if Bart and Lisa knew every intimate detail of my life and were examining me to find out about how or why I had come to be in this outrageous circumstance. I didn’t exactly feel like I was being judged by them - they appeared playfully concerned - but I began to feel great shame, like I’d done something beyond naughty! Like I had crossed a line one should never cross, caused a cosmic violation. It was so emotionally intense and unexpected that I felt violated.'


...or other types of hallucinatory voices coming from some part of the body.

Excerpt from the Temple:

'Almost impossible to describe accurately with words, but my entire body shattered and the fragments became other things - the most physical visionary experience I've had, bar none. My internal dialog became an external voice, and the fragments of what used to be my arm sat muttering "arm.arm.arm.arm." - very much a "language defining reality" sensation.'


(d)persistent delusions of other kinds that are culturally inappropriate and completely impossible, such as religious or political identity, or superhuman powers and abilities (e.g. being able to control the weather, or being in communication with aliens from another world);

Differences between acute intoxication and persistent delusion aside, aliens/entities from another world form a repeating constant of salvia divinorum experiences.


(e)persistent hallucinations in any modality, when accompanied either by fleeting or half-formed delusions without clear affective content, or by persistent over-valued ideas, or when occuring every day for weeks or months on end.

Persistency problems again, but half-formed delusions abound:

Excerpt from The Vaults of Erowid:


'The entire bowl was smoked in four giant hits. By the last hit, I was drooling quite a bit and a heavy sweat had broken out all over my body. Again, I felt wrenched and as if I had been struck. I sat in the dark room, vibrating and trying to figure out what the hell had just happened. I was suddenly unclear as to where I was, who I was and what I was doing. The whole room seemed to be vibrating. I was aware of my room mates and knew that I knew them, but didn't have a clue as to who they were. I felt distinctly not-me, like I was someone else. The "else" in question seemed to be at times an Indian, participating in some sort of ritual, and at times a kid in some seventies juvenile delinquent B-movie. I felt a pressing need to figure out what was going on, and this quickly brought me out of it. There was an after buzz that lasted approximately twenty minutes, though I felt slightly "up" all night.'


(f) breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech, or neologisms;

Here, a person posts a transcription of a recording of themselves speaking under the influence of a kappa opioid agonist.


(g)catatonic behaviour, such as excitement, posturing, or waxy flexibility, negativism, mutism, and stupor.

By fortune, young adults with video cameras unwise enough to inflict salvia on themselves have charitably donated priceless critical evidence that could not be ethically collected in a research setting.


(h)"negative" symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses, usually resulting in social withdrawal and lowering of social performance; it must be clear that these are not due to depression or to neuroleptic medication.

Humans undergoing extreme distortions of consciousness can be pretty quiet in between delusional outbursts.


(i)a significant and consistent change in the overall quality of some aspects of personal behaviour, manifest as loss of interest, aimlessness, idleness, a self-absorbed attitude and social withdrawal.

Not exactly something that's relevant to acute intoxication. Not that this sort of thing doesn't often come with chronic smoking of plant matter, but only the most foolhardy could consume salvia at length due to it's so frequently being an utterly wretched experience.