RESIDUAL SCHIZOPHRENIA(Guide)

This article is a detailed overview of residual schizophrenia and discusses some pertinent aspects related to this disorder.

Also, this article reveals possible symptoms, diagnostic aspects and possible treatments which offers insight into this problem.

WHAT IS SCHIZOPHRENIA? 

Schizophrenia is a chronic mental disorder in which patients experience reality abnormality.

It can result in behavior that impairs daily functioning of the patient and can eventually disable them.

It is characterized by disordered thoughts, abnormal behaviors, and antisocial behaviors. 

It is a psychotic illness, and people with schizophrenia no not identify reality at times.

It affects about 1.1% of the world population and is commonly diagnosed between the ages of 16-25.

Schizophrenia can be a hereditary disease and runs in families. It can affect men 1.5 times more commonly than women. 

Doctors have recognized four varieties of schizophrenic disorder, paranoid schizophrenia, hebephrenic schizophrenia, catatonic schizophrenia, and simple schizophrenia. 

There are three further categories being post schizophrenic depression, undifferentiated or disorganized schizophrenia and residual schizophrenia, also known as chronic schizophrenia.

Catatonic schizophrenia and hebephrenic schizophrenia tend to have the most full-blown prognosis; there are no consistent differences in the treatment or progress in these various types of the disease. 

WHAT IS RESIDUAL SCHIZOPHRENIA?

Some patients recover successfully from minor episodes of acute schizophrenia.

Others can be less fortunate in the matter and develop a chronic illness in which they have reduced functions.

When the patient no longer displays prominent symptoms, they are considered to be residual schizophrenia.

In such cases, the schizophrenic symptoms generally have lessened in severity. 

When an individual has a history of at least one episode of schizophrenia, but currently has no symptoms such as delusions, hallucinations, etc. they are considered to have the residual type of schizophrenia.

Their individuals in their daily life have no visible symptoms, and they are not medically affected by their past episodes of schizophrenia, but there is always a risk of them have another episode and the disease to progress from thereon. 

The residual type of schizophrenia is distinguished by a lack of prominent symptoms and is considered a less severe diagnosis.

Mostly negative symptoms are seen, and the person can lack the normal range of thoughts.

Symptoms of Schizophrenia (in general)

There are two types of symptoms of schizophrenia, positive and negative.

1. Positive Symptoms

Positive symptoms of the disease include recurrent hallucinations in which the patient can experience environments and occurrences that are not real, delusions leading to paranoid thoughts about things.

Some good examples of positive symptoms of schizophrenia include patients hearing and seeing things that are not real and do not exist or did not happen in reality.

Patients can act inappropriately, usually talking in made-up languages and not make sense when they talk.

2. Negative Symptoms

Negative symptoms of this disease are normally observed when a patient with schizophrenia lacks a normal range of thoughts and behaviors and usually had disorganized thoughts.

Negative symptoms can include having a lack of interest in daily life, showing flat or blunted emotions, being unable to stay clean and get dressed on their own.

Patients are unable to do simple chores sometimes and are withdrawing from others.

For people to be diagnosed with the disease, the positive symptoms must last for at least up to six months.

Once the positive symptoms of the disease start to deteriorate, negative symptoms are likely to persist for a long period.

During this phase, a person is diagnosed and classified with having residual schizophrenia. 

Prominent symptoms for residual schizophrenia from among all symptoms are psychomotor slowing,  blunting of affect, passivity, and lack of initiative, poverty of quantity or content of speech, poor nonverbal communication by facial expression, eye contact, voice modulation, and posture, poor self-care, and social performance.

Symptom Profile in Teenagers

Schizophrenia symptoms in teenagers are similar to those in adults, but the condition may be more difficult to recognize.

This may be in part because some of the early symptoms of schizophrenia in teenagers are common for typical development during teen years and can easily be overlooked by parents.

Residual schizophrenia had higher chances to be prevalent in teenagers because of these reasons, such as:

• Withdrawal from friends and family in their daily lives as their thoughts may be disturbed
• A drop in performance at school
• Trouble sleeping
• Irritability or depressed mood
• lack of motivation

Compared with schizophrenia symptoms in adults, teens may be less likely to have delusions and More likely to have visual hallucinations.

Prevalence of Residual Schizophrenia

Residual schizophrenia is not one of the more common types of schizophrenia.

It is less common than paranoid schizophrenia and undifferentiated schizophrenia, the category where most cases fall when not defined as paranoid.

Residual schizophrenia is considered a mild form of the illness because it usually does not disrupt your daily life the way other types might.

Recovery is possible with medication and proper care. 

Doctors also suggest physiotherapy if the patient had a number of episodes in the past.

In general, 1 percent of people across the world have schizophrenia.

Anyone can develop this condition, but it happens equally in both men and women.

While children can develop schizophrenia, this is rare; the average age to develop schizophrenia for men is 18 and, for women, 25. 

It is also uncommon to develop schizophrenia in the middle to an older age.

Residual schizophrenia is even more uncommon as usually when a patient is diagnosed with schizophrenia; it goes on for life. 

Is is Preventable?

It’s not known what causes schizophrenia, but researchers believe that a combination of genetics, brain chemistry, and the environment contributes to the development of the disorder in individuals around the world.

Problems with certain naturally occurring neurotransmitters dopamine and glutamate and some other chemical imbalance may contribute to schizophrenia. 

Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia.

Researching doctors around the globe can not be certain about these changes, but they have gathered enough evidence that concludes and indicate that schizophrenia is a brain disease.

People with schizophrenia often lack awareness that their difficulties stem from a mental disorder that requires medical attention.

So it often falls to family or friends to get them help. 

There is no way to prevent residual schizophrenia, as it is unknown when there will be another episode of it.

However, people with residual schizophrenia can maintain better functioning through continuing to take their prescribed medicines as given by the doctor, receiving support from family, friends, and the wider community, going to therapy and life skill sessions, and going to regular medical appointments. 

Medication, therapy, and support all aim to prevent acute episodes of schizophrenia, which are the times when the person experiences the most symptoms and has the greatest difficulty functioning.

Following the basic steps that lead to a more disciplined life and a healthy diet for these patients have proven to be a vital element in decreasing the chances for the patient to have another episode of schizophrenia.

HOW IS IT DIAGNOSED?

Diagnosis of schizophrenia involves ruling out other mental health disorders and determining that symptoms are not due to substance abuse, medication, or a medical condition.

Determining a diagnosis of schizophrenia may include:

Physical Exam

Full physical exams may be done to help in ruling out other problems that may be prevailing and causing the onset symptoms of the patient and can also check for any other related complications or symptoms.

Testing & Screening

Screenings and blood tests may be done to rule out conditions that have similar symptoms, and screening for alcohol and drugs are recommended as they may have contributed to the symptoms that schizophrenia patients prevail. 

Psychiatric Evaluation: 

A doctor or a mental health professional observes the mental status of patients by observing them and checking basics like dressing, thoughts, moods, asking questions, etc. doctors ask about violence and suicidal thoughts.

Family history and personal thoughts are also considered in diagnosing schizophrenia. 

Treatment Options

Residual schizophrenia symptoms can be helped with medications that balance mood and thinking.

Taking these drugs can help perform normal tasks in daily life, like staying clean and getting dressed on their own.

In addition to the medications that any physician prescribes, your doctor may also recommend psychotherapy to help cope with symptoms. 

Medicines that enhance the progress of your neurotransmitters are usually recommended by physicians.

Antipsychotic medicines are vital treatments for different types of schizophrenia.

Both older and modern types of antipsychotic medicines can be used.

The modern types produce fewer side effects on the patients, but some of the older medicines like clozapine are very effective in treating people who are unable to respond to newer antipsychotics. 

Doctors try several medications before finding the person that responds best to the given conditions of the individual.

People with residual schizophrenia who are also experiencing anxiety or depression may be treated with anti-anxiety medications and antidepressants.

Psychosocial Interventions

Once psychosis recedes, in addition to continuing on medication, psychological and social (psychosocial) interventions are important.

These may include:

Individual therapy. Psychotherapy can help to normalize the thought patterns of the patient.

Learning to cope with stress and identify early warning signs of relapse can help people with schizophrenia manage their illness on a much better scale.

Social skills training. Social skills training focuses on improving communication and social interactions and improving the ability to participate in daily activities.

Family therapy. This provides support and education to families dealing with schizophrenia.

Family support has proven to be a very vital element for people struggling to cope with schizophrenia.

Vocational rehabilitation and supported employment: This focuses on helping people with schizophrenia prepare for, find, and keep jobs in the modern world as it can be very difficult for patients to cope with everyday tasks in a normal way.

Recovery Prospects or Outlook

Currently, there is no cure for schizophrenia. Since schizophrenia is a chronic episodic disease, periods of recovery may be a good time to start self-helping strategies that can help in limiting the time and frequencies of future episodes.

People tend to get better within five years of experiencing their first onset symptoms, and often their symptoms may get worse if not cared for properly. 

Coping with schizophrenia can be a lifelong process, and recovering patients may never be symptom-free.

Patients need to develop the support that they need and create a satisfying and purposed life.

The medication treatment plans may change from time to time, but with self-help, support, and therapy, patients can get better. 

Most people with schizophrenia suffer from symptoms either continuously or intermittently throughout life and are often severely stigmatized by people who do not understand the disease.

It also has an enormous effect on the economy since its treatment costs between 32.5-65 Billion dollars annually. 

Some common second-generation antipsychotics are Aripiprazole (Abilify), Asenapine (Saphris), Brexpiprazole (Rexulti), Cariprazine (Vraylar), Clozapine (Clozaril) and Iloperidone (Fanapt) and the first generation antipsychotics include chlorpromazine, fluphenazine, haloperidol, and perphenazine.

There are other cheaper than second-generation antipsychotics, which can be a factor when long term treatment is necessary.

Some Helpful Resources:

1. Cognitive-Behavioral Social Skills Training for Schizophrenia: A Practical Treatment Guide
2. The Disordered Mind: What Unusual Brains Tell Us About Ourselves
3. On Conquering Schizophrenia: From the Desk of a Therapist and Survivor
4. Schizophrenia for Dummies
5. Living with Schizophrenia: A Family Guide to Making a Difference (A Johns Hopkins Press Health Book)

Frequently Asked Questions:

References

1. What is schizophrenia
2. Residual schizophrenia: symptoms and treatment
3. A guide to hallucination
4. A brief guide: Schizophrenia Symptoms
5. Symptoms of Schizophrenia in Teenagers
6. How to find out about schizophrenia