Identifying the type and stage of schizophrenia can take months of patient observation and dozens of diagnostic tests. It is because this psychopathology has many varieties, each with its specific symptoms. They determine the methods of treatment and prevention. Recurrent schizophrenia is one of the milder forms of schizophrenic spectrum disorders. Let’s discuss Recurrent schizophrenia in more detail.
Recurrent Schizophrenia Causes
Recurrent schizophrenia, included in ICD-10 section F25, is also called recurrent and circulatory schizophrenia. In addition, the diagnosis of schizoaffective psychosis, identified with recurrent schizophrenia, can be found in the medical literature. It is characterized by signs of affective disorder, where a person’s mood changes dramatically, hallucinations, paranoid delusions, and catatonic syndrome, which are seen in most patients with schizophrenia.
The exact causes of psychopathology are unknown. However, the leading role in its development is given to hereditary factors. If someone in the family has a mental illness, the likelihood of becoming ill increases. The closer the degree of relationship, the greater the risk.
There is also an assumption that recurrent schizophrenia develops more often in hypertensive personalities – socially cheerful, flexible, and active. It is less common in schizoids, who are withdrawn people prone to loneliness and fantasy.
However, these are only disabling factors that may never manifest themselves. Typically, the disorder occurs suddenly after a severe somatic illness, severe stress, psychological trauma, etc. In women, circular schizophrenia can begin after childbirth.
Recurrent schizophrenia occurs in less than 1% of people.
It is not always possible to determine the trigger during diagnosis. But the most important thing for doctors is to make an accurate diagnosis. May examine the patient for several days to two to three months. It is due to the broad symptomatology of the disease.
Recurrent Schizophrenia Symptoms
The treatment of the disorder is conditioned by its form. Recurrent schizophrenia can develop in different scenarios, each of which differs in its symptoms. But the disease always begins approximately the same way. Most often, the symptom period is in young adulthood. The attacks occur once every year or two. Before the exacerbation, the following features of the patient’s behavior are observed:
- Apathy, lack of initiative;
- Activity without purpose;
- Complete inactivity;
- insomnia and nightmares;
- Increased anxiety.
Subsequently, the illness develops in several stages. Let’s consider the classical clinical picture of recurrent schizophrenia:
- Initial stage. The first emotional disorder is observed: the person’s mood changes without obvious reasons. Prolonged activity for several hours may abruptly turn into apathy. Somatic symptoms without clear signs of a specific illness are periodically disturbing.
- Staging. Adequate perception of the surrounding reality is preserved, but delusions appear. Sometimes it seems to the person that someone is directing them. And this “someone” can be both real and representative of the imaginary world.
- Antagonistic delusions. As a rule, patients in such cases begin to divide all people into good and evil, those who care for them and those who are against it. It seems to the patient that there is a struggle in the world, the outcome of which largely depends on him.
- Oneiroid lucidity. The patient freezes in one pose, think, and does not react to external stimuli. Usually, at such moments, he is visited by fantastic visions.
- They are fading from the attack. The main symptoms disappear. In their place, signs of the beginning of the disease – disorders of the emotional background appear.
After the attack, there is a period of remission, during which the person can lead a habitual way of life. The next exacerbation may occur only after several years. It depends on its type, prevention, and the individual characteristics of the patient’s body.
Recurrent Schizophrenia Diagnostics
In any schizophrenia, a differential diagnosis should be made to rule out similar syndromes and illnesses. Should differentiate Recurrent disorder from manic-depressive psychosis. According to the ICD-10, symptoms such as:
- Affective disturbances;
- Catatonic disorders.
If at least 1 of these signs does not go away within 14 days, the question of schizophrenia arises. The form and stage of schizophrenia are then determined.
MRI scans, CT scans, EEG scans, blood tests, etc., are standard methods in such pathologies. In addition, a conversation with relatives is conducted. The doctor must know if the patient has any family history of mental illness.
Recurrent Schizophrenia Treatment
Treatment of recurrent schizophrenia is based on psychotherapeutic methods and the administration of antipsychotic medications. Therapy is carried out in an inpatient setting, but only during a period of exacerbation. After it, the patient is discharged, but treatment continues for at least 2-5 months. Must consider the psychiatrist’s recommendations throughout life to prevent the next attack.
Practice shows that 25% of patients go into prolonged remission after the first exacerbation for about 5-8 years. Half of the patients do not fully recover and therefore need constant monitoring.
Prevention of Recurrent Schizophrenia
Schizophrenia is diagnosed for life. The person will have to see a psychiatrist systematically, take medications, and sometimes even go to the hospital. The main task of psychotherapy is to form a critical attitude towards the illness. He needs to understand that he is ill to see a doctor in the case of a relapse.
There are several directions of psychotherapeutic treatment during remission:
- Cognitive-behavioral helps relieve residual symptoms, correct the attitude towards the patient and normalize social contacts.
- Cognitive training: aimed at developing thinking and other cognitive functions such as memory, perception, etc.
- Interpersonal psychotherapy – individual consultations with the therapist, discussing the current condition.
The problem is that any factor can provoke an attack – stress, an infectious disease, divorce, dismissal, a change of residence, etc. should prevent such situations. If this does not turn out to be the case, it is better to contact a psychiatrist or psychologist immediately.
Patients with schizophrenia are not advised to travel because a change of time zone may trigger another attack.
Of course, the person will have to give up bad habits. It is desirable to lead a healthy lifestyle, sleep at night, walk in the fresh air, not drink alcohol, not smoke, etc.
See Als0: Remission in schizophrenia.
The patient’s relatives play a significant role in this context. They, too, consult with a specialist to understand how to respond to a person with schizophrenia. A few simple rules:
- If the person often talks to himself, listens, dialogues with someone, constantly interrogates and looks around, he is probably developing auditory hallucinations. Discuss his experiences with him, but gently. There is no need to yell at him or make fun of him. It may provoke aggression or withdrawal. Do not try to convince the sick person that the voices and visions are not real. He will not believe you and, therefore, will distance himself from you even more.
- If the man suddenly changes his attitude toward you, is afraid of everything, constantly suspects something, and says strange things about conspiracies, adultery, and persecution, he is likely developing delirium. Please do not get into arguments with him. It is better to become an accomplice to the sick person so that he trusts you and shares his thoughts. Trying to change the schizophrenic’s mind about something during a seizure may aggravate the situation.
- If the person is both agitated and stupor, remaining in the same posture for long periods (even 1-2 minutes), he may develop catatonia. Please do not argue with the person, and do not try to get him out of his stupor. It is better to have a “heart-to-heart” talk with them or, if necessary, call a doctor.
On the whole, the prognosis for intermittent schizophrenia is favorable. The main thing is to follow the doctor’s recommendations. Then remission can be very long, and the attack is short and not as dangerous as other schizophrenic disorders.