Remission in schizophrenia is a period when the patient has no symptoms of the pathology and feels well in general. But it does not mean complete elimination of the illness. Periods of remission can be of different duration. To understand when and under what conditions stabilization is possible, you need to observe the course of the disease and monitor its stages. Let’s find out what types of remissions exist and how long they last.
Short Definition of Schizophrenia
It is a psychotic disorder characterized by the following symptoms:
- Psychosis (loss of connection with reality);
- Delusions (false beliefs);
- Hallucinations (false sensations);
- Violation of logical thinking;
- Narrowing the range of emotions;
- Loss of ability to work and social activity.
The causes of different forms of schizophrenia in psychiatry are not precisely established, but a large role is assigned to genetic and environmental factors. The first signs of pathology most often appear in adolescence or adolescence. However, episodes (one or more) of severe symptoms must last for at least six months before a diagnosis is made. Schizophrenia is treated with medication, cognitive therapy, and psychosocial rehabilitation.
Forecasting the progression of a person’s mental illness, particularly schizophrenia, is not an easy task, but it is very important. Correct and timely assessment of the condition means an early start of treatment, consequently, the maximum improvement in the quality of life of the patient and the possibility of achieving sustained remissions.
Acute stage of schizophrenia
The acute stage of schizophrenia lasts about a month and a half to two months and is characterized by the following signs:
- Weakening of productive thinking;
- Deterioration of memory;
- Loss of interest in work and social activities;
- Lack of initiative and energy.
The patient generally becomes lazy and apathetic, may cease to follow his appearance, and rejects personal hygiene skills. Increased anxiety, tension, and irritability may also be observed with the loss of strength. The person begins complaining about headaches, and peculiar reasoning about the world order, showing the so-called “magical thinking.” This term in psychiatry refers to thinking based on the belief that thoughts or desires alone can bring about a change in the external situation without any real action.
In the acute stage of schizophrenia, the patient may complain of rapid heartbeat, pauses in a heartbeat, excessive sweating, or chills. He may slow his speech and suddenly stop talking as if listening to something.
During this phase, it is possible to predict the course of the disease. If promptly and successfully stopped the first psychotic episode in the hospital, the subsequent course would be more favorable to complete remission.
Schizophrenia Stabilization Stage
This stage occurs after the acute stage lasts from six months or more. The patient has not strongly pronounced signs of psychosis, residual delirium, and short-term disorders of perception. For example, at the request to do something, he reacts in the exact opposite way or does not react at all. Impairment of memory, attention, the disorder of logical thinking, and other symptoms become noticeable.
Remission in schizophrenia
The type of its course largely determines the prognosis of this psychotic disorder. In several cases, it manifests itself in one or two episodes, and then there is a period of stabilization. How long remission in schizophrenia lasts – there is no clear answer. If there are no pathology symptoms for more than six months, then we speak about going into remission. However, this does not mean that the patient is cured. If, after the first episodes, he is prescribed timely and complete treatment, the probability of remission is much higher. We can discuss long-term remission if the “lull” has lasted for five years. Is life-long stabilization possible? So far, no such cases have been registered in psychiatry.
Statistics say that about 30% of people diagnosed with schizophrenia have a chance to return to normal life without experiencing any discomfort. The other 30% of patients may retain partial symptoms of the disorder. At the same time, they can lead a social life despite some deterioration in memory and thought disorders. If these patients see a psychiatrist regularly, follow all the prescriptions, and take them, they stand a good chance of living to a ripe old age.
But 40 percent of people registered for schizophrenia have difficulty with the disease. They cannot normally work or study and have reduced abilities for social adaptation and, in general, independent life. Their quality of life is markedly reduced. In such cases, the patient has usually been prescribed a disability and continued medication administration, and he needs regular hospitalization to support his condition.
Remission in schizophrenia: types
In psychiatry, there are several types of remissions in which schizophrenia has certain signs. The clinical picture depends on the basic diagnosis and the course of the illness. Let us consider them in detail.
Hypersthenic type of remission
In this type of temporary stabilization, patients with schizophrenia are inclined to monotonous, monotonous, even continuous, but hyperactive activity from which they do not get tired and do not complain of a feeling of fatigue. The circle of their other interests is narrowly limited. Concerning others, they show pettiness, pedantry, and self-centeredness. Extreme punctuality is observed in the performance of the daily schedule. In this hypersthenic type of remission in schizophrenia, clinic patients are industrious and fulfill all simple duties.
For example, we can cite a patient with chronically current schizophrenia who guarded the vegetable garden at the clinic where he was staying. He slept very little, tirelessly doing his duty near the beds, let no one near him, was very focused on performing his duties, and even had a homemade shotgun, which did not fire. The patient would not let anyone touch the plants and was on guard day and night. It is a typical example of the hypersthenic monotonous activity observed during remission in paranoid and catatonic forms of schizophrenia.
The hypersthenic type of remission also occurs in patients diagnosed with severe, continuous catatonia during puberty. Achieved remission due to therapy and noted a combination of hypersthenic manifestations with pronounced mental infantilism. The patient aspired to monotonous, one-sided activity, along with displaying the features of childishness.
Asthenic type of remission
In this type of remission, patients have noticeably pronounced asthenia. It is a condition manifested by rapid fatigue, abrupt mood changes, restlessness, irritability, impatience, and inability to perform sustained mental and physical work. The patient also suffers from disturbed sleep and intolerance to sharp smells, bright lights, and loud sounds—phases of excessive excitement alternate with phases of lethargy and literal physical exhaustion. Tearfulness, capriciousness, and memory disorders are possible.
Fast fatigability is characteristic of asthenic remission in schizophrenia. Patients complain of an emotional collapse of energy even after minor mental strain or any bright impressions. In the remission of the asthenic type, any work is very difficult.
The person coming home falls without energy, saying they need to rest and are so tired that they cannot move. Biorhythms are often disrupted: sleepiness attacks during the day, and insomnia or poor, intermittent sleep at night. At the same time, some patients may not complain about their condition but, on the contrary, hide it from others.
Hypochondriac type of remission
Hypochondria symptoms manifest as an increased focus on uncomfortable sensations throughout the body or fear of the possibility of a return to a condition. Severe anxiety about the state of health comes to the fore. Affective and neurosis-like symptoms are observed in some patients.
Many patients in remission of the hypochondriacal type believe they have no current psychopathology. However, they remember the disease they suffered from and fear its return. Such people try to avoid emotional outbursts, even positive ones, much less stressful situations. At home and work, they behave in a balanced manner, and at the same time, they are active and active.
Thymopathy type of remission
This type of remission is characteristic of the course of schizoaffective psychosis when the premorbid is inclined to fluctuations in mood. It is characterized by periods of unexplained falls and a rise in mood, which can last from several hours to several weeks.
Hyperthymic signs – heightened activity, hypervigilance, aspiration for rough activity, search for novelty – are characteristic of the period of enthusiasm. Patients are drawn to noisy, unfamiliar companies, and there is a tendency to have a good time. The capacity for assiduity and systematic work is absent. Often sexual desire is inhibited, and casual relations arise.
In periods of decline, lethargy and apathy set in, against which there are sometimes outbursts of irritability and disobedience. Some tend to use alcohol or other intoxicating drugs to dull the condition.
If, after the first episode of schizophrenia, the patient receives treatment and takes medication, a relapse may occur with a 20% chance.
If treatment is ignored, the likelihood of an exacerbation increases to 70%. In general, the prognosis of the disease worsens significantly after the second episode of schizophrenia. The longer an exacerbation lasts, the more pronounced its symptoms are, the more difficult it is to deal with, and the worse the consequences for the patient.