Residual schizophrenia: signs, treatment

Schizophrenia is an unpredictable mental illness that can occur in different forms. Some patients have only one or two attacks in their entire lives, while others lose touch with reality in a matter of months. Some types of pathology develop rapidly, and some of them progress over years. Residual schizophrenia belongs to the second type. It is characterized by a long period of negative phase. In the article we will look at what its features are.

Total information

Schizophrenia is a polymorphic endogenous disease that affects the human mental apparatus. Polymorphism suggests that it occurs in different forms. The reason for its origin is the internal state of the psyche, so we are talking about an endogenous nature. As for the direct impact on a person, schizophrenia affects the brain, or more precisely, thinking and emotional reactions.

This psychopathology is detected in approximately 1% of people. The peak incidence occurs at 20-28 years in men, and at 26-32 years in women. However, schizophrenia is also diagnosed in children, as well as in the elderly. Moreover, it is often combined with anxiety disorders, depression, alcoholism and drug addiction, so it is not always possible to identify the disease at an early stage.

Many people believe that schizophrenia is a split personality. Others believe that it is always accompanied by hallucinations. In fact, “multiple personality disorder” is too simple a word for such a complex disease. In schizophrenic disorders, there is a disintegration of personal qualities and a person’s loss of contact with reality.

If we talk about hallucinations, they do not occur with every type of pathology. Moreover, the presence of this symptom may not indicate a schizophrenia spectrum disorder. Residual schizophrenia refers to those forms in which hallucinations are extremely rare.

Possible complications

With delayed diagnosis and lack of adequate treatment for the disease, encephalopathy progresses and is accompanied by the appearance of persistent organic brain damage.

As a result, such manifestations of the residual period may develop as:

symptomatic epilepsy with secondary generalized seizures;
early onset of Parkinson's disease (tremor, walking impairment);
cerebral palsy (lack of movement in the limbs, muscle spasticity);
vegetative-vascular dystonia (fluctuations in blood pressure, pulse);
oligophrenia (impaired cognitive functions of the brain).

Residual encephalopathy often occurs with impaired speech formation, which leads to difficulties in the child’s socialization processes and entails serious psychological problems.

Residual schizophrenia

Residual schizophrenia is also called residual schizophrenia. It is registered after exacerbations (attacks) and is characterized by stable remission without pronounced signs of psychosis. Although it can be asymptomatic, it is also impossible to say that a person is completely healthy in this condition.

The patient does not have hallucinations or delusions, but his behavior is very passive and uninitiative. The patient may say that everything is fine. However, relatives are usually concerned about his behavior and are very worried. They have cause for concern, since the disease can worsen at any time, despite the fact that sometimes a person remains in this state for years without any signs of psychosis.

Residual schizophrenia is rare - only 2.6% of patients.

Treatment is carried out not only during attacks, but also during remission. The further development of the pathology depends on its quality.

Prevention

Prevention of the development of residual encephalopathy in children consists of:

regular visits to specialists during pregnancy to identify early signs of pathology, as well as indications for emergency or planned delivery;
immediate treatment and prevention of various injuries and infections (bacterial, viral, fungal) in a child;
maintaining a daily routine and physical activity appropriate to the baby’s age;
proper balanced nutrition;
the mother’s refusal of bad habits (smoking, drinking alcohol) during pregnancy and feeding.

Causes

Nothing is known for sure about the causes of any schizophrenia. Scientists have not yet been able to describe the mechanism of development of the pathology. It has only been established that its focus is in the brain, but what exactly causes its occurrence and how it progresses remains a mystery.

Doctors have at their disposal a group of factors that can hypothetically provoke schizophrenia:

Genetic predisposition. The likelihood of developing psychopathology increases if it has been identified in relatives. The closer the relationship, the higher the risk. A child with two schizophrenic parents has less than a 50% chance of avoiding the disease.
Brain abnormalities. MRI shows that in schizophrenic disorders there is enlargement of the ventricles, atrophy of the hippocampus, temporal lobes and other areas.
Problems that arise during pregnancy. We are talking about injuries, infections, unhealthy lifestyle of the mother, complicated childbirth and birth injuries.
Social conditions. In families with alcoholics, drug addicts, psychopaths and other antisocial personalities, children may develop schizophrenia, psychopathy, schizoaffective disorder and other diseases. He definitely cannot avoid psychological trauma.
Upbringing. As a rule, schizophrenics appear in families with oppressive parents or, on the contrary, in permissive conditions. Also, the likelihood of developing psychopathologies increases if no one cares for the child at all and no one loves him.
Dependencies. Alcohol, drug addiction and smoking are not the direct culprits of schizophrenia, but they can serve as an impetus for its development. If a person began using psychoactive substances in childhood, the risks increase markedly.

Also, trauma, acute or chronic stress, prolonged depression, etc. can lead to schizophrenia or its exacerbation. The patient's medical history is studied carefully, but it is not always possible to draw a direct connection between one or another event and an attack of psychopathology.

Symptoms of the condition in children

Residual encephalopathy in children has many manifestations. The most common of them are:

violations of the intellectual-mnestic sphere, expressed in mental retardation, poor performance at school;
hydrocephalus external or internal;
motor disorders in the form of paresis and paralysis;
convulsive syndrome.

The presence of certain signs depends on the degree of damage to the brain substance and the location of the main foci of ischemia in it. At the initial visit to the doctor, only one of the syndromes may be observed, but in the absence of adequate therapy, residual encephalopathy tends to progress and over time, existing symptoms will worsen and new ones will appear.

How not to miss alarming symptoms?

The first “bells” of the disease in infants are extremely difficult to identify; a weak or delayed cry after birth, suppression of the sucking and grasping reflexes, and hemodynamic disturbances: heart rate and blood pressure should be alarming. Later the following symptoms are observed:

irritability, tearfulness;
sleep disorders - the child either sleeps around the clock or wakes up every half hour;
hypertrophied reaction to a sharp sound, turning on the light;
periodic shaking of the whole body;
frequent persistent regurgitation or hiccups after feeding;
throwing the head back;
eye rolling;
convulsions;
increased or decreased muscle tone in the limbs.

If the pathology was not assessed in time, then encephalopathy can be suspected in older children:

delayed psychomotor development;
appetite disorders;
dyssomnia (sleep disorders);
frequent headaches and dizziness;
mental disorders (apathy, tendency to depression, aggressiveness, decreased criticism);
an increase in the size of the skull due to hydrocephalus.

Tips for parents

The only thing that can be advised to parents in view of such a disease as residual encephalopathy is to be more attentive to their children. When the first signs of pathology appear, you must immediately contact a specialist, since the sooner therapy is started, the greater the chance of reducing the effect of hypoxia on neurons.

Also, falls of children and infections cannot be ignored - they can cause the death of brain cells, and therefore require timely diagnosis and adequate treatment. The health of children is priceless; it is better to contact the pediatrician once again with a question of interest than to later try to cope with a neglected process.

Symptoms

Any form of schizophrenic disorder has two sets of symptoms - positive and negative. The first are called so not because they are “good”, but because they are a consequence of the activity of the psyche. Typical signs of productive symptoms are hallucinations and delusions.

In such a state of psychosis, the patient may be inadequate. Moreover, in most cases, he does not realize that he is sick, even if he sees grandiose and fantastic hallucinations.

The nature of hallucinations is individual. Some hear voices, while other patients see or touch objects that do not exist in reality.

With residual schizophrenia, there are usually no such symptoms. The patient is in a negative phase, which is revealed when the mental apparatus is passive. The main manifestations of residual schizophrenic disorder are:

No signs of psychosis for 1 year or more. This period is considered as remission.
Decreased motivation. A person does not want anything and does not strive for anything. He is not even interested in those activities that previously brought him pleasure.
Emotionality. The patient may not respond to others and circumstances, including dramatic and difficult situations.
Fatigue, weakness, both physical and moral, loss of strength. As soon as the patient takes up something, he immediately gets tired. Performance is practically zero.
Closedness. With residual schizophrenia, a person does not want to communicate with anyone, he strives for loneliness, his speech is empty and meaningless. Often he tries not to speak at all.
Poor hygiene. Over time, the patient stops taking care of himself - washing, shaving and washing clothes. Outwardly, he looks unkempt, but he doesn’t care.
Strange behavior. The patient may talk loudly to himself in the presence of others, wander, collect garbage and bring it home (pathological hoarding).
Superstitions. Belief in both the supernatural and complete absurdities, superideas, telepathy, etc. is possible.

To make a diagnosis of residual schizophrenia, four of the following symptoms must be observed. In this case, it is necessary to avoid organic brain damage, dementia and chronic depression, which are also characterized by negative symptoms.

Delusions, illusions, catatonia and hallucinations can occur in residual schizophrenia, but they are mild and do not cause vivid emotional experiences.

A person can be in remission for more than a year, but an exacerbation is possible at any time.

Then positive symptoms will appear, and probably even more intensely than during the previous attack. But this depends on how well the patient follows the doctor’s recommendations, as well as on the timeliness of therapy if the condition worsens.

Diagnosis and treatment

Diagnosis for schizophrenia, like treatment, is not interrupted even during remission. The patient must periodically visit a psychiatrist and undergo certain tests. Thanks to this, you can notice signs of exacerbation at the initial stage. The same applies to therapy. In fact, after a diagnosis of schizophrenia is made, a person becomes a patient for the rest of his life, regardless of how often attacks occur or whether they occur in principle.

Treatment methods for exacerbation and remission are somewhat different. For residual schizophrenia, the following medications and techniques are used:

Taking antipsychotic drugs. Their task is to restore dopamine activity, which malfunctions in schizophrenic diseases. With negative symptoms, the production of dopamine is insufficient, which is why the person is passive.
Taking antidepressants. With their help, it is possible to activate the psyche by stimulating the production of serotonin.
Hospitalization. In remission, the patient usually remains at home. He might even get a job. But sometimes doctors advise temporarily going to the hospital and undergoing additional examination, especially if there is a risk of an exacerbation.
Psychotherapeutic sessions. They are individual and group. They are considered one of the most effective methods of treating schizophrenia during remission. The patient can talk to the doctor and also listen to other patients with similar diseases. This helps improve your mood and increase motivation.
Working with loved ones. Relatives of a schizophrenic person consult a psychiatrist about the rules of communication with their loved one who is in the grip of schizophrenia. They must learn to communicate with him and quickly identify the symptoms of an attack.
Education. In some cases, the patient is taught vocational skills so that he or she can work. Locking yourself in is much more dangerous. It is much more productive for the patient to work. In this case, monotonous and manual labor is preferable.

In general, treatment for residual schizophrenia is aimed at the patient’s social adaptation and reducing the negative impact of the pathology on the psyche.

Diagnostic measures

Diagnosis of residual encephalopathy is aimed at identifying its causes and confirming diffuse damage to the brain substance.

For this use:

physical examination to clarify the neurological status;
laboratory tests (clinical blood and urine analysis, biochemical blood test, blood sugar test, thyroid hormones);
EEG to identify epileptogenic foci;
neurosonography in children under one year of age, since their large fontanel is not yet closed;
Echo-ES is also an ultrasound method that can help identify signs of hydrocephalus;
Doppler ultrasound, duplex or triplex scanning of the vessels of the head and neck - to clarify pathology and abnormalities in the development of the circulatory system that can lead to brain hypoxia;
CT or MRI - these neuroimaging technologies make it possible to detect foci of ischemia, changes in the ventricles and subarachnoid space, and clarify the cause of the observed clinical picture.

The list of diagnostic measures is compiled only by the attending physician after a detailed examination. This will help in some cases to avoid a tomography, since young children will have to be under anesthesia to perform the procedure.

Forecast

Predicting the development of schizophrenia is quite difficult. It is incurable, and therefore a person is constantly at risk. He has the opportunity to prolong remission, but only with an integrated approach to his health, not only mental, but also physical.

The earlier schizophrenia manifests itself, the more devastating its consequences.

It is recommended to exercise (except extreme sports), eat right, walk in the fresh air every day, take vitamins and communicate with other people. Alcohol, drugs, smoking and other psychoactive substances should be eliminated from your life forever. If you adhere to these rules, the risk of a new attack is noticeably reduced.