Schizophrenia can lead to a complete disintegration of the personality when a person loses his connection with reality. But some forms of schizophrenia are accessible and do not cause serious complications. Latent schizophrenia, also called latent, belongs to the second group of varieties. Let us describe this disorder in more detail.
Latent schizophrenia (less frequently, false schizophrenia) gets its name due to the lack of manifestation, mild course, and absence of psychotic symptoms observed in other types of schizophrenic spectrum disorders. The ICD-10 does not list this pathology. Usually, it is classified as a schizotypal disorder in official classifications.
Latent schizophrenics are characterized by stubbornness and capriciousness. They suffer from a lack of willpower (abulia) and therefore do not keep promises and cannot make decisions. In connection with this, there is a lack of desires. Such patients want practically nothing. Outwardly they look lethargic or frivolous.
Because of the lack of willpower, many people perceive patients with latent schizophrenia as lazy and thoughtless. Even relatives think of them this way, believing that abulia is a consequence of the person’s deliberate choice not to do anything. If he does plan something, in most cases, the initiatives remain in the plans but are not implemented.
See Also: What is Sluggish Schizophrenia?
Sometimes patients commit ill-considered acts or begin to pursue any matter that has suddenly come to mind vigorously. Hyperdulia is the name for this condition. This disorder is characterized by alternating hyperdulia and abulia with sharp hops in the middle. Emotional coldness is often associated with agelessness. The patient becomes indifferent to loved ones, friends, and those hobbies which previously brought pleasure.
But the main feature of latent schizophrenia is the absence of psychotic symptoms. The person is typically oriented in space and time, is aware of his personality, and does not suffer from delusions or hallucinations. It partly complicates diagnosis since the other signs are not always indicative of the development of a pathological process.
Latent schizophrenia is detected in about 3% of people who come to a psychiatrist with a suspected mental disorder.
In general, we can distinguish four main features of latent schizophrenia:
- The disease begins early (sometimes, the first signs manifest in childhood).
- The clinical picture does not resemble the symptomatology of diseases of the schizophrenic spectrum.
- The patient has acute neurotic and psychopathic reactions.
- Psychopath-like features are formed in the patient, but no obvious personality deformation is observed.
Left untreated, the disease progresses, resulting in more pronounced affective disorders.
Story of Latent Schizophrenia
Latent schizophrenia was first described in 1911 by Eugen Bleuler, who noted that the pathology was a consequence of other, more severe schizophrenic disorders. Hermann Rorschach claimed that such patients seemed adequate outwardly, but when tested, they gave the same results as other patients with schizophrenia. The author also stressed that psychotic symptoms in this disease, if they manifest themselves, are due to lack of treatment and the presence of chronic distress.
In 1916 and 1920, E. Bleuler published textbooks for psychiatrists which described the latent form of schizophrenia as follows: “Patients are irritable and overly sensitive to external factors. They also have severe mood swings.” Bleuler adds, however, that such patients often seek medical help themselves. Usually, it is not typical for people with schizophrenia because they consider themselves healthy.
Beginning in the 1960s, domestic psychiatrists considered latent schizophrenia a sluggish or low-progressive form of the schizophrenic spectrum. Today, there are no clear criteria that can accurately substantiate this diagnosis either. Therapy is prescribed individually in each case, based on the patient’s condition and the number and intensity of symptoms.
Latent Schizophrenia Causes
The exact causes of latent schizophrenia are unknown. As a rule, doctors state the following factors which hypothetically, i.e., under certain circumstances, can provoke the disorder:
- Genetic predisposition;
- Deficiency of neurotransmitters – serotonin, dopamine, etc.;
- craniocerebral traumas, brain diseases;
- Alcoholism and severe intoxication;
- Psychosocial factors: upbringing, environment, etc.;
- psychotraumatic situations, distress.
Some people believe that schizophrenia occurs after severe stress or trauma. However, these can only trigger the development of an exacerbation of a disorder that already existed. And sometimes it can take years to develop, masquerading, for example, as OCD – obsessive-compulsive disorder. In any case, it is practically impossible to establish an authentic connection between this or that trigger and the schizophrenia symptomatology.
Latent Schizophrenia Symptoms
The symptomatology may vary from case to case. One patient has a wide range of symptoms, while another has only a few. In general, it is possible to allocate some typical symptoms of latent schizophrenia, in the presence of which there is a reason to see a psychotherapist:
- Disregard social and moral norms;
- A lack of willpower (abulia), absence of desires and interests;
- Eccentric, defiant behavior;
- Excessive religiousness, superstition;
- High level of anxiety, a mild form of paranoia;
- The desire for loneliness, autism;
- High mood swings;
- Dissatisfaction with own and other people’s appearance;
- Inconsistent thinking, inconsistency of thoughts;
- Illusions, slight defects in perception;
- Use of complex and confusing language in speech.
These signs are not specific. One can speak of a mental disorder only when at least three symptoms have been present for three months or more. Usually, they appear for some time, and then there are so-called “lighter intervals” when the person becomes normal again. After that, the symptoms can be more varied and intense.
Latent schizophrenia affects the sphere of self-awareness. Patients state that they forget that they are adults. It is as if they lose their sense of adulthood, expressing it in such words as “I become a child,” “I return to childhood,” etc. They begin to perceive the world around them through the eyes of a child. Because of this, the future seems too uncertain to them. It interferes with making decisions, showing initiative, and taking responsibility.
Depersonalization, i.e., a distorted perception of oneself, is detected in 30% of patients. Approximately 24% of patients develop fears that troubled them in childhood, and 19% of people with latent schizophrenia withdraw from the adult world altogether, cutting off contact with them. They prefer to communicate with children because they understand children’s interests better.
Many patients with latent schizophrenia have higher education and high achievements in science and art.
Hypersensitivity to external factors is manifested in the fact that the patient can withdraw into himself because of insignificant trifles, take offense or make a scandal. The patient is characterized by willfulness, secrecy, and suddenness. In this case, the range of his interests narrows, absenteeism from work or school becomes more frequent, and the number of conflicts in the family increases. Usually, these symptoms in the context of schizophrenia are called a prodromal state.
Also, in latent schizophrenia, it is worth paying attention to the patient’s signs of autism traits. A person behaves as though he is alone when surrounded by friends or a group of people. If he does talk to someone, he behaves too intrusively, talks too much, interrupts, argues, and can be rude. He does not accept someone else’s point of view. At the same time, he does not admit that he is aggressive or intrusive.
Latent Schizophrenia Types
In 50% of patients, latent schizophrenia begins to manifest itself in childhood, often in adolescence. But the clinical picture differs from the classical types of schizophrenic disorders. Symptoms affecting the psychopathic, neurotic, and affective spheres are mainly observed. Aggression, motor rituals, and gross compulsions are usually absent. Autism and delirium are also not detected.
Symptoms of the disorder may appear in childhood, but the diagnosis is not made until the child reaches adolescence, as the initial signs may disappear over time without any treatment. However, doctors say the disease can return after 10 or even 25 years.
Latent schizophrenia in adolescence is accompanied by depression and apathy. Cognitive functions are also affected. In particular, thinking problems are noticed. As the disorder progresses, signs such as gratuitous anxiety and fears occur without connection to external or internal factors.
If no therapy is prescribed, the disease progresses, leading to the formation of schizoid characteristics, which include:
- Emotional deficits;
- Inadequate reactions to external stimuli;
- Loss of communicative skills;
- The formation of a disharmonious personality complex;
- Hysterical traits;
- Psychasthenia, infantilism, etc.
In 37% of patients, the disorder progresses to delayed exacerbations that may not be evident for decades.
Women usually show signs of the disease later in life. They also live longer with similar diagnoses.
Such patients are often referred to as odd or bizarre. It is related to the inadequacy of their emotions. Simply put, their reactions to certain events do not correspond to the event itself. They may get upset for no apparent reason but do not show excitement in a stressful situation.
Patterns of behavior built by society and morality are of no interest to them because their own rules and values are formed in their brain.
Latent Schizophrenia Diagnosis
Latent schizophrenia maintains a mild, mild course throughout. It differentiates it from the passive form, characterized by seizures with intense symptoms, delusions, and hallucinations. However, latent schizophrenia is difficult to distinguish from the initial stages of sluggish schizophrenia. The patient must be followed up for a long time, from 3 months to 2 years.
Symptoms of the disorder may appear in childhood, but the diagnosis is not made before the child reaches adolescence because the primary signs may eventually disappear without treatment. However, medics say the disease may return ten or even 25 years later.
Diagnosis is carried out in several stages. First, the doctor must get acquainted with the patient’s complaints and relatives. The medical history is studied, including the relatives, if there were people with mental disorders in the family. The next step is to prescribe standard methods:
- General blood test;
- EEG; MRI;
- CT SCAN;
- Thyrotropic hormone test;
- Cortisol levels, etc.
If necessary, the patient is examined by specialists in related specialties. The main task is to separate latent schizophrenia from borderline personality states.
Latent Schizophrenia Treatment
Treatment is carried out in two directions – medication and psychotherapy. If addressed in time, the disorder is quite successfully corrected. It is usually treated as an outpatient. Soft-acting neuroleptics are prescribed as medications in small dosages. They allow you to reduce anxiety and normalize perception.
Psychotherapy is based on cognitive-behavioral therapy, during which the patient learns to communicate and control their own emotions. The patient needs to understand that they are ill and how they look from the outside during their inadequate actions. In general, this type of treatment is aimed at:
- Development of defense mechanisms;
- Establishing family relationships;
- Learning to control the illness;
- Correction of the overall personality structure.
Sessions of group, individual, and family therapy are practiced. Relatives will also have to learn how to communicate with their sick loved ones in a new way.
The symptoms of latent schizophrenia are dangerous to ignore. Many fear they or their family members will be diagnosed with a “life-threatening” disorder. Sometimes a person is even happier that their child has a drug addiction and not a schizophrenic disorder. However, the latter, if left untreated, can be more dangerous.
The most severe complication is death, including death by suicide. More serious mental illnesses are also possible. If you begin treatment immediately, however, the likelihood of a favorable outcome increases many times over. The person has a chance to extend remission and live a whole life.