Stages of Schizophrenia
Heather Barnett Veague, Ph.D., who is an important psychologist, talks us about three stages of schizophrenia: Prodromal, Acute and Residual stages. Schizophrenia, for other doctors and researchers, can be divided into four stages: Prodromal, Acute, Remission and Relapse. Let us see all of them.
Three stages
Prodromal Stage. The first stage is called the prodromal stage and refers to the year before the illness appears. The term prodrome is derived from the Greek word prodromos, meaning “something that comes before and signals an event”.10 In medical terms, a prodrome refers to the early symptoms and signs of an illness that come before the characteristic symptoms appear.
For example, chicken pox is described as having a prodrome of a few days characterized by fever, headache, and loss of appetite. This is followed by the rash more commonly associated with chicken pox, making definitive diagnosis possible.
People in the prodromal stage of schizophrenia often isolate themselves, stay alone in their bedroom a lot and stop spending time with family or friends. Their school or work performance suffers and they may show signs of decreased motivation, loss of interest in activities, and inappropriate or blunted emotions.
The signs of the prodromal stage are not specific to schizophrenia. That is, someone who is experiencing these behaviors might be depressed or have some other problem. That is why one cannot identify the prodromal stage until the active phase is reached. Until a patient experiences psychotic symptoms, a physician cannot diagnose schizophrenia.
Interestingly, signs of the prodromal stage have been identified as early as childhood. Some innovative research by Elaine Walker and her colleagues at Emory University has involved examining childhood home movies of adults with schizophrenia, and without schizophrenia. Raters, who were unaware of which children had schizophrenia as adults, found that the children who were to develop schizophrenia as adults were often clumsy and awkward.
Although clumsiness is not unique to children who will develop schizophrenia, this sign is seen significantly more often in children at risk for the disorder. Thus, signs of schizophrenia might be present several years before psychotic symptoms emerge.
Family members can be invaluable when it comes to identifying the prodrome of schizophrenia. Relatives might sense that something “isn’t quite right” with their family member, even if they’re not certain whether it is just a bad mood, a normal developmental stage, or the influence of alcohol or illegal drugs.
Family members of patients with schizophrenia have identified several behaviors that indicated to them that something was wrong with their relative. Although the prodromal signs differ from patient to patient, nearly all family members of schizophrenia patients indicate that their relative experienced social withdrawal. Following, you will find ten examples of behaviors that relatives of schizophrenia patients noticed in their family member during the prodromal stage of schizophrenia.
Remember that many behaviors that are part of the prodrome are within the normal range of experience.
Acute Stage. When someone is experiencing psychotic symptoms such as hallucinations, delusions, or grossly disorganized behavior, they are said to be in the acute or active stage of schizophrenia. The active phase indicates full development of the disorder. When patients are in the active phase, they appear psychotic. Their behavior may become so extreme or bizarre that hospitalization is necessary. Once a patient is brought to medical attention, a mental health professional will observe the patient, question the patient, and question the patient’s family members if they are available. The goals of the first assessment are to ascertain when the strange behaviors began, how long they have lasted, and rule out the use of alcohol or drugs. Patients who are grossly psychotic are difficult to interview, so they might be treated with antipsychotic medication upon admission. Indeed, patients in the active phase of schizophrenia often need antipsychotic medication to alleviate their symptoms. With medication, many symptoms of schizophrenia disappear. If not treated with medication, this phase may last for several weeks or months. In fact, without treatment, the active phase may go on indefinitely. In very rare instances, the active phase resolves itself and symptoms disappear without treatment.
Some patients have only one episode of schizophrenia, entering the active stage only once. It is more common for patients with schizophrenia to experience multiple episodes of the disorder, with brief periods of being free of symptoms between episodes. For many patients, the active phase is characterized by positive symptoms.
Residual Stage. The final stage of schizophrenia is called the residual stage. The features of the residual phase are very similar to the prodromal stage. Patients in this stage do not appear psychotic but may experience some negative symptoms such as lack of emotional expression or low energy. Although patients in the residual stage do not have delusions or hallucinations, they may continue to experience strange beliefs. For example, when Kevin is in the residual stage of schizophrenia, he might still be convinced that his coworkers don’t like him, even if he no longer believes that they are broadcasting a radio show about him.
Four stages
The difference with the previous classification is the two final stages:
Remission and relapse. After an active phase, positive symptoms get better, especially with treatment, and life may be more "normal." This is called remission. But symptoms may get worse again, which is called a relapse. You may have this cycle of symptoms that get severe and then improve.
In each cycle, the positive symptoms may become less intense, but the negative symptoms may get worse. You may have few or many cycles before you are able to stay in remission.
Within five to ten years, you may develop a unique pattern of illness that often stays the same throughout your life. It also is possible that you will have fewer relapses as you get older and may even not have symptoms.
Tips for avoiding relapse
- Learn how to recognize the first signs of relapse, such as not wanting to do things with others, and have a plan to deal with it and get help right away.
- If you need help deciding whether to see your doctor, read about some of the reasons people don't get help and how to overcome them.
- Take your medicine, even if you're feeling better. This makes a relapse less likely. Learn some ways to help you remember to take your medicine.
- If side effects are making your life hard, talk with your doctor to see whether you can try a different medicine.
- Treat health problems that may occur along with or because of schizophrenia. These include obesity, substance abuse, type 2 diabetes, and heart and lung problems.
- Stay in counseling or therapy, and continue with your recovery plan.
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