Is schizophrenia intermittent? An attack of schizophrenia: what is it and how to deal with it? Schizophrenia: causes and predisposing factors, signs, symptoms and manifestations of the disease - video.

Mental disorder is necessarily manifested by external signs. Attacks of schizophrenia can be different in character, course. They indicate the form and severity of the disease. Having studied their manifestation, the specialist prescribes the appropriate treatment.

Mental disorders in people have always caused fear and confusion among healthy people. Healers have long tried to figure out where people with strange behavior come from. And only two centuries ago it was possible to describe the attacks of schizophrenia, the symptoms, and in the 20th century, doctors identified the types, forms and stages of the disease, its causes.

The course of schizophrenia involves the development of seizures from time to time.

According to the findings of a number of scientists who have been working to identify the causes of the disease for many years, there are a number of factors that provoke mental disorders.

Heredity- transmission of the disease at the genetic level from parents, grandparents, etc.
Psychoanalytic. The disease occurs against the background of stress, infectious diseases, injuries, overvoltage.
Dopamine- an excess of this hormone affects the work of nerve impulses.
Dysontogenetic- the disease is already embedded in the human genes, and due to external factors - trauma, stress, infection, etc., it "floats" out.

How the disease manifests itself

Seizures of schizophrenia have a different character, it all depends on the type and form of the disease. But there are common symptoms that are inherent in almost all forms of mental illness.

Speech is disturbed, there is delirium, a sharp switch to another, strange topic, tongue-tied.
Complete lack of initiative, lack of will, independent actions.
Inadequate reaction to actions and statements, lack of emotions.
Megalomania, persecution, the constant manifestation of one's own exclusivity.

Seizures in mental disorders

With an exacerbation of mental illness, first of all, anxiety is observed for no reason.
The sufferer is subjected to an "attack" of non-existent voices, communicates with ephemeral personalities, beings.
There is insomnia, the patient often wakes up, walks from corner to corner.
There is a loss of appetite or vice versa, voracity. In this state, a schizophrenic can eat a portion many times the daily allowance.
There are outbreaks of aggression, anger, or the sick person hides in a corner, refuses to communicate with loved ones, completely withdraws into himself.
There is a desire to run away from home.
The patient becomes distrustful, may stop recognizing a loved one.

A person during an attack begins to worry for no reason

Important: the listed attacks in medicine are called psychosis. They require urgent relief, for which it is necessary to seek help - call a psychiatric team.

Alcoholic psychosis

Very often, with prolonged abuse of alcohol, drug use, psychoses occur, which are confused with the first attack of schizophrenia (manifesto). The symptoms caused by a powerful intoxication of the body are really similar to a mental illness, but there are still distinctive features:

Delirium tremens. Due to the abolition of alcohol, drugs, the patient sees phantom creatures: devils, goblin, spiders, flies, etc., trying to catch them. A common type of hallucination is the head of a dog, with which the sufferer may speak or be afraid of it. The characteristic signs of the behavior of a mentally ill person who had an attack of schizophrenia are reflected in the video, of which there are a huge number on the network.
hallucinations. Voices are heard that can threaten, order, criticize. Patients in such cases are sure that others also hear non-existent sounds.
Rave. Occurs against the background of prolonged alcohol intoxication, characterized by persecution mania, fear of being poisoned.
With prolonged alcohol consumption, brain cells are affected, there is encephalopathy. An alcoholic develops symptoms of schizophrenia: delusions, hallucinations, attacks of aggression, anger, he becomes uncontrollable. In severe cases, hospitalization in a specific institution is required.

The most dangerous is the acute phase of schizophrenia

How long does a schizophrenia attack last?

It is impossible to determine with accuracy how long a schizophrenic seizure lasts. It all depends on the individual indicators of a person, the form of the disease, aggravating circumstances. According to general data, there are several phases and each of them takes a certain period of time.

Acute (first) phase. The exacerbation lasts up to two months. The patient's thinking, memory worsens, loss of interest in work, study, and favorite activities is possible. The condition is aggravated by apathy, untidiness, lack of initiative. The patient often has excessive sweating, headache, dizziness, palpitations, anxiety, fears. With timely therapy, the prognosis is favorable, up to a long-term remission.
After effective relief of seizures, there is stabilization stage. The process takes more than six months. The patient's symptoms are mild, in rare cases delirium, hallucinations appear. Without medical intervention, the acute phase continues to acquire threatening signs: memory loss occurs, delusional thoughts intensify, the patient hallucinates continuously. As a result, a complete loss of appetite, attacks of aggression with screams, howls are possible. Suicidal tendencies are obsessive.

An attack of schizophrenia: what to do

The main thing is not to bring a person's condition to acute phases. It is important to pay attention to the first signs of the disease and seek qualified help. If the process is started, you should calm the patient and at the same time call an ambulance for psychiatric help. It is impossible to cope with a mental illness without the intervention of a specialist.

During the acute phase, the patient may be dangerous to others

It is necessary to influence the brain cells, the patient's behavior with neuroleptic, nootropic drugs. The acute phase can carry a risk to life, both the patient and others. Often in a state of seizure, persons suffering from schizophrenia attacked people, maimed, committed violence. For those who are faced with the diagnosis of "schizophrenia" for the first time, a video of an attack will tell you in detail what a sick person looks like, what characteristic facial features and behaviors are manifested. Thanks to this, it is possible to determine the disease without a doubt and turn to the right medical structure.

Recurrent schizophrenia (periodic) is the most favorable form of the disease. It is characterized by the alternation of attacks of mental illness with long light intervals, during which productive symptoms are absent or minimally expressed. Personality changes are absent or mild, this form is similar to.

How often do seizures occur? About a third of patients suffer only one exacerbation during their lives, in others the disease reminds of itself with a frequency of 1 time in 2-3 years or more often. However, no matter how often attacks are repeated, pronounced personality changes with a characteristic schizophrenic defect do not develop.

As a rule, the onset of the disease occurs at a young age. Seasonal exacerbations may also be observed.

Etiology

The main role among the causes of the development of the recurrent form of schizophrenia is given to heredity. Someone from close relatives suffered from a mental disorder or psychopathy.

There is a hypothesis that hyperthymic individuals most often suffer from this form of the disease, less often the periodic form of schizophrenia occurs in schizoids.

Attacks of the disease can occur spontaneously, in some cases a serious illness of internal organs, stress, intoxication or childbirth (as happens with) becomes a provoking factor.

Symptoms

The most typical symptoms of recurrent schizophrenia are affective, oneiroid and catatonic manifestations, delusions.

Affective disorders can proceed both in depressive (with apathy, low mood, self-condemnation) and manic type (apathy prevails, an irresistible desire to do something, fun). The most common catatonic manifestations are stupor and agitation (they are described in detail in the article about).

There may be problems with sleep (insomnia or, conversely, vivid dreams), groundless anxiety. Sometimes patients have a feeling that something terrible will happen soon, that they can go crazy.

Characteristics of a classic seizure

In typical cases, an attack of recurrent schizophrenia develops according to the following pattern:

Emotional disturbances appear first. Periods of high spirits, when enthusiasm prevails, you want to do something, alternate with inactivity, bad mood, autonomic disorders.
The next stage is the appearance of delirium. It seems to a person that a performance or a film is being played around him, and all those around him are actors, and someone is directing them (staging syndrome). In the statements of others, the patient begins to catch the hidden meaning, understandable only to him alone. It seems to a person that someone controls his thoughts, puts them into his head.
With further progression of the disorder, an antagonistic delusion syndrome occurs. The patient begins to think that his environment consists of representatives of good and evil, who are fighting among themselves (antagonistic delusions). Delusional ideas of grandeur may also arise.
At the peak of exacerbation, oneiroid and catatonic disorders are noted. A person can freeze in one position, not respond to appeals to him. Oneiroid stupefaction of consciousness may also occur, when visions of fantastic content flash before the eyes of the patient.
During the regression of exacerbation, emotional disorders again become the leading symptoms.

Not always an attack of periodic schizophrenia goes through all the stages. Its development can stop at any one stage, and the manifestations of subsequent stages will be only short-term episodes against the background of protracted main symptoms.

On average, an attack lasts several months, but it can be shorter (from a few days to a couple of weeks).

Similarities with TIR

Recurrent schizophrenia shares many similarities with manic-depressive psychosis, or bipolar personality disorder as it is now called. It has a fairly favorable prognosis, most exacerbations are accompanied by affective disorders. However, the symptoms of recurrent schizophrenia may be delirium, catatonic disorders, which is not typical for MDP.

The affective disorders that occur with periodic schizophrenia, although similar to, are blurred, there can only be individual symptoms. For example, if a person shows signs of depression, then all three symptoms of the classic triad (low mood, motor and intellectual retardation) will not be present at the same time.

In the interictal period, phases of mood changes similar to can be observed. However, since emotional disorders are not pronounced, the person continues to lead a habitual way of life, work, and does not turn to a psychiatrist.

Perhaps 2 variants of the course of the periodic form of schizophrenia: with the same type of seizures or with different ones.

The nature of exacerbations depends on the age of the onset of the disease:

if the onset of the disease occurs before the age of 30, then most often the attacks are accompanied by oneiroid-affective disorders;
if the disease debuted at an older age, then oneiroid-catatonic manifestations are not characters, but delirium or emotional disturbances predominate.

Remission

Although remissions in this disease are of a fairly high quality, some may still be, for example, emotional disturbances.

Personal changes may appear in the form of asthenia, contact restrictions, decreased activity. Some patients become pedantic, passive, subservient. Others begin to overly monitor their mental health - in every possible way they avoid information, situations that can negatively affect the psyche.

Treatment

Antipsychotics (haloperidol, triftazin, truxal, rispolept) are used to treat recurrent schizophrenia. These drugs act on catatonic, oneiroid manifestations, delirium, help to cope with arousal.

If the patient has severe depressive disorders, then antidepressants (fluvoxamine, paroxetine) can be used. A specific drug is chosen based on which symptoms dominate - anxiety or depression.

Having studied their manifestation, the specialist prescribes the appropriate treatment.

Causes of mental disorders

According to the findings of a number of scientists who have been working to identify the causes of the disease for many years, there are a number of factors that provoke mental disorders.

Heredity - the transmission of a disease at the genetic level from parents, grandparents, etc.
Psychoanalytic. The disease occurs against the background of stress, infectious diseases, injuries, overvoltage.
Dopamine - an excess of this hormone affects the work of nerve impulses.
Dysontogenetic - the disease is already embedded in the human genes, and due to external factors - trauma, stress, infection, etc., "floats" out.

How the disease manifests itself

Seizures of schizophrenia have a different character, it all depends on the type and form of the disease. But there are common symptoms that are inherent in almost all forms of mental illness.

Speech is disturbed, there is delirium, a sharp switch to another, strange topic, tongue-tied.
Complete lack of initiative, lack of will, independent actions.
Inadequate reaction to actions and statements, lack of emotions.
Megalomania, persecution, the constant manifestation of one's own exclusivity.

Seizures in mental disorders

With an exacerbation of mental illness, first of all, anxiety is observed for no reason.
The sufferer is subjected to an "attack" of non-existent voices, communicates with ephemeral personalities, beings.
There is insomnia, the patient often wakes up, walks from corner to corner.
There is a loss of appetite or vice versa, voracity. In this state, a schizophrenic can eat a portion many times the daily allowance.
There are outbreaks of aggression, anger, or the sick person hides in a corner, refuses to communicate with loved ones, completely withdraws into himself.
There is a desire to run away from home.
The patient becomes distrustful, may stop recognizing a loved one.

Important: the listed attacks in medicine are called psychosis. They require urgent relief, for which it is necessary to seek help - call a psychiatric team.

Alcoholic psychosis

Delirium tremens. Due to the abolition of alcohol, drugs, the patient sees phantom creatures: devils, goblin, spiders, flies, etc., trying to catch them. A common type of hallucination is the head of a dog, with which the sufferer may speak or be afraid of it. The characteristic signs of the behavior of a mentally ill person who had an attack of schizophrenia are reflected in the video, of which there are a huge number on the network.
hallucinations. Voices are heard that can threaten, order, criticize. Patients in such cases are sure that others also hear non-existent sounds.
Rave. Occurs against the background of prolonged alcohol intoxication, characterized by persecution mania, fear of being poisoned.
With prolonged alcohol consumption, brain cells are affected, encephalopathy occurs. An alcoholic develops symptoms of schizophrenia: delusions, hallucinations, attacks of aggression, anger, he becomes uncontrollable. In severe cases, hospitalization in a specific institution is required.

How long does a schizophrenia attack last?

Acute (first) phase. The exacerbation lasts up to two months. The patient's thinking, memory worsens, loss of interest in work, study, and favorite activities is possible. The condition is aggravated by apathy, untidiness, lack of initiative. The patient often has excessive sweating, headache, dizziness, palpitations, anxiety, fears. With timely therapy, the prognosis is favorable, up to a long-term remission.
After effective relief of seizures, a stage of stabilization occurs. The process takes more than six months. The patient's symptoms are mild, in rare cases delirium, hallucinations appear. Without medical intervention, the acute phase continues to acquire threatening signs: memory loss occurs, delusional thoughts intensify, the patient hallucinates continuously. As a result, a complete loss of appetite, attacks of aggression with screams, howls are possible. Suicidal tendencies are obsessive.

An attack of schizophrenia: what to do

The main thing is not to bring a person's condition to acute phases. It is important to pay attention to the first signs of the disease and seek qualified help. If the process is started, you should calm the patient and at the same time call an ambulance for psychiatric help. It is impossible to cope with a mental illness without the intervention of a specialist.

Schizophrenia. paroxysmal schizophrenia.

It includes two main flow options - recurrent and paroxysmal-progredient. Recurrent (periodic) schizophrenia proceeds most favorably, personality changes, even with many years of prescription of the disease and a large number of attacks, are minimally expressed. Exacerbations of the disease manifest themselves in the form of well-defined attacks, separated by remissions, often very long. Attacks are manifested by depressive or manic states, acute fantastic delirium with a distorted perception of the environment, up to dream (oneiroid) clouding of consciousness, symptoms of catatonia. In remission, as a rule, working capacity is restored, patients critically assess the transferred psychosis, of the residual disorders, mild mood variability is most characteristic. Attack-like progredient (coat-like) schizophrenia also occurs in the form of acute psychotic attacks with remissions between them, however, the severity and duration of attacks and the low quality of remissions determine a more unfavorable course. In remissions, features of a schizophrenic defect are noticeable already in the first years of the disease, residual delusional, hallucinatory and other disorders. Schizoid psychopathization is characteristic with a weakening of emotional contacts, a tendency to fence off, a decrease in productivity up to disability. Consciousness of the disease is formal, without full criticism. Acute psychotic states in schizophrenia usually require hospitalization.

6. Treatment. The most common psychopharmacotherapy Acute conditions are stopped by intramuscular administration of neuroleptics: chlorpromazine - mg, haloperidol - mg, tizercin - mg, triftazin - mg, leponex up to 600 mg (in the absence of effect from other drugs), etc., with severe affective disorders in cases of depression, they are prescribed antidepressants (amitriptyline-mg, melipramine-mg, etc.), for the relief of manic excitement - antipsychotics. Effective treatment with insulin coma. With resistance to other methods of treatment, electroconvulsive therapy is used. Long-term maintenance therapy with psychopharmacological drugs is needed, often in a deposited form (moditendepo, etc.)

Timely social and labor rehabilitation of patients with lost ability to work is important; they are attracted to work in medical and labor workshops, special workshops; patients with disabilities are selected for professional work with a sparing regimen, a reduced volume of tasks, etc. The examination of working capacity is carried out by VTEK.

Patients with schizophrenia are subject to psychiatric registration and constant monitoring in a neuropsychiatric dispensary, depending on the form of the disease and condition. Control over the regularity of prescribed maintenance therapy can be carried out by the paramedic of the district (especially in rural areas. If the first signs of a deterioration in the mental state are found, after consultation with a psychiatrist, the patient can increase the doses of drugs or prescribe their injection on an outpatient basis. In case of side effects of psychotropic drugs, the paramedic the feldsher-obstetric point can increase the dose of the corrector (cyclodol) or slightly reduce the dose of the drug.

Schizophrenia

According to statistics, schizophrenia is one of the leading causes of disability worldwide. So far, there is no treatment that guarantees the complete elimination of the disease forever.

General information

Schizophrenia is a mental illness that is characterized by severe disturbances in emotional reactions and thought processes. With schizophrenia, uncontrolled emotions and movement disorders are manifested.

Varieties of schizophrenia

All types of schizophrenia are divided into two large groups:

continuous. Symptoms intensify and grow steadily, while deep remissions are not observed.
Paroxysmal. There are periods of remission between attacks. This feature makes paroxysmal schizophrenia similar to manic-depressive psychosis.

Types of continuous schizophrenia:

Malignant (hebephrenia). In most cases, it manifests itself in adolescence. It is characterized by regression of behavior, emotional dullness, inactivity. Slows down mental development in childhood. There is a marked decline in academic achievement. Often, patients are forced to stop studying in regular schools.
Progredient. Symptoms appear in people over the age of 25 years. A typical symptom is frequent delusional disorders. At the beginning of the development of the disease, crazy ideas can manifest themselves in jealousy, the desire to invent something. Over time, persecution mania develops, it seems to the patient that someone controls his thoughts. There are also auditory and visual hallucinations.
Low-progressive (sluggish). Most often it begins to manifest itself in adolescence. The disease develops over the years, personality changes increase gradually. Psychopathic, neurosis-like disorders predominate.

Types of paroxysmal schizophrenia:

Paroxysmal-progredient. Combines paroxysmal and continuous flow. The disease can manifest itself in only one attack, after which a long remission begins. Subsequent attacks become more severe. The attack is acutely variable, the patient's condition is changing rapidly.
Periodic (recurrent). It is characterized by acute prolonged attacks. It is manifested most often by schizoaffective psychoses. Between attacks there are periods of deep remission. During seizures, the perception of the surrounding world is disturbed. This type of schizophrenia can manifest itself at any age.

Danger to the body

Schizophrenia severely limits the social activity of the patient. With schizophrenia, it is difficult to study at school, college, work, communicate with others. The patient's options are limited. During attacks, he is not able to adequately think and behave. The load on the nervous and cardiovascular system increases, the risk of alcoholism and drug addiction increases. In addition, among schizophrenics there is an increased number of people with suicidal tendencies.

Self-treatment

Currently, self-treatment of schizophrenia is not possible. Only a doctor is able to make a correct diagnosis and prescribe treatment. In a large number of cases, schizophrenics require hospitalization and constant monitoring by a specialist. Therefore, if you suspect schizophrenia, you should immediately consult a doctor.

Schizophrenia is very rare. About 1% of the world's population is more schizophrenic, this is a fairly large number.
Drug addiction and alcoholism are a direct path to schizophrenia. Alcohol and drug use are risk factors, but by themselves they cannot provoke schizophrenia. Psychedelic drugs greatly increase the risk of an attack.
Schizophrenia is a sign of genius. Some famous people did suffer from schizophrenia, but there is no connection between this disease and outstanding mental abilities.
Schizophrenia is a hereditary disease. If one parent has schizophrenia, the child has a 25% chance of developing it.
Schizophrenics are aggressive. In most cases, patients behave quite calmly and do not pose a danger to others. However, in some cases, uncontrolled aggression during attacks is indeed observed.

Reference books

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Schizophrenia

SCHIZOPHRENIA is a mental illness that occurs chronically in the form of seizures or continuously and leads to characteristic personality changes. The main symptoms of schizophrenia are: splitting of mental activity and emotional-volitional impoverishment. The term "schizophrenia" literally means "splitting of the soul" ("schizo" from Greek - splitting, "fren" - soul, mind). With the splitting of mental activity, patients gradually lose contact with reality, there is a fence from the outside world, withdrawal into themselves, into the world of their own painful experiences. This condition, called autism, manifests itself in the form of a tendency to solitude, isolation, while the patient's thinking is based on a distorted reflection in the mind of the surrounding reality. Characterized by the fragmentation of thinking in the form of "verbal okroshka", empty sophistication (reasoning), symbolic thinking, when the patient explains individual objects and phenomena in his own, only meaningful sense for him. Crazy ideas can arise primarily, through a painful interpretation of real facts and events, and secondarily, that is, on the basis of impaired perception (hallucinations).

Crazy ideas can be of different content: persecution, poisoning, witchcraft, exposure, jealousy.

Characteristic for patients with schizophrenia is the delirium of physical influence, when it seems to them that they are being affected by hypnosis, x-rays or some other radiation (“special rays”) with the help of special installations, transmitters, both from the Earth and from space. Patients hear in their heads the "voices" of those people who act on them, control their thoughts, emotions, movements. They can also see “movies” or “special pictures” shown to them by imaginary people (whose voices they hear), smell various smells, experience painful sensations in the body and head in the form of burning, transfusion, drilling, shooting.

Emotional-volitional impoverishment is characterized by emotional dullness, affective indifference to everything around, and especially emotional coldness towards relatives and relatives. Sometimes patients become rude, spiteful towards relatives, they treat their parents as strangers, calling them by name, patronymic. Patients cease to perform their duties, take care of their appearance (do not wash, do not change clothes, do not comb their hair), wander, commit absurd acts.

Often, emotional-volitional impoverishment is accompanied by lack of will (aboulia), patients are not interested in anything, they have no plans and desire to implement them, they can lie in bed for days without doing anything. Disappears interest in study, work, there is isolation, fenced off from the outside world. The symptoms of schizophrenia depend on the stage of development and the form of the course of the disease. The main forms of schizophrenia are continuous and paroxysmal.

Continuous schizophrenia is characterized by a gradual aggravation of painful manifestations with a succession of neurosis-like, hallucinatory-delusional and catatogenic hebephrenic disorders (see Psychomotor agitation). With sluggish schizophrenia, a very slow decline in mental productivity occurs and the picture of the disease is limited to mild psychopathological disorders, such as obsession, phobia, hysterical, depersonalization manifestations, overvalued ideas and paranoid delusions (inventions, jealousy, etc.). Usually, personality changes are limited to isolation with imprints of strangeness in behavior and lifestyle while maintaining vitality and social adaptation.

With an average type of progression of the process and the predominance in the clinical picture of such hallucinatory-paranoid disorders as delusions of persecution, physical impact, the phenomena of mental automatism (paranoid schizophrenia), negative changes (autism, emotional devastation, apathy) are steadily increasing. Malignant (juvenile) schizophrenia begins in adolescence (rarely in childhood) with negative disorders: the vivacity of interests is lost, isolation appears, the emotional sphere becomes impoverished. Crazy ideas of various content, catatonic and hebephrenic disorders, the phenomena of the Kandinsky-Clerambault syndrome are characteristic. After 2-5 years, a deep personality defect, emotional dullness, abulia develop.

Paroxysmal schizophrenia includes two main variants: periodic (recurrent) and stubby-progressive (fur-like).

Recurrent schizophrenia proceeds most favorably, manifested by recurrent attacks and periods of remission between them, often very long .. It occurs in women much more often than in men, and begins in adulthood (25-35 years) symptoms, acute delusional states, oneiroid stupefaction (may be combined with catatonic disorders). An attack usually begins with an increase or decrease in mood, then anxiety, fear, and confusion join. It seems to patients that something incomprehensible is going on around them, scenes and performances are specially arranged and played out for them. Memories, surrounding phenomena and facts are given a special fantastic meaning.

In the future, depending on the mood, delirium can develop in different ways. In a depressive state, ideas of guilt, the struggle between good and evil may arise, often with the victory of evil forces, the “devil”, “scarlet spirits”, and, as a result, suicidal thoughts and attempts. An elevated mood is characterized by ideas of greatness, special significance and role in the world (I am the ruler of the Universe, I have a special mission, etc.). In the midst of an attack, confusion occurs: the patient reincarnates, lives in a fantasy world, on another planet or in a different time period (more precisely, contemplates his life, as in a dream). The reverse development of an attack can be both gradual and quite fast. The number of attacks during the course of the disease varies (from 1-2 to annual deterioration). Sometimes there are bouts of schizophrenia lasting from a few days to 2 weeks. Women may develop before menstruation. With the onset of menstruation (on the 2-3rd day), the condition usually improves.

Personality changes, which usually occur after repeated attacks, are characterized by a decrease in activity, the appearance of resentment, vulnerability, and sensibility. In the interictal period, mood swings are often noted. During periods of remission, working capacity is restored, patients critically assess the transferred psychosis, and mood variability is usually noted from residual disorders. Even with many years of prescription of the disease and a large number of attacks, personality changes are slightly expressed.

Attack-like progredient (fur-like) schizophrenia proceeds in the form of attacks with subsequent remissions, but the reverse development of the attack does not end with a complete restoration of mental health; obsessive, hypochondriacal, and paranoid disorders remain. The true onset of the disease usually occurs in childhood, when isolation, isolation appear, adaptation in children's groups (in kindergarten, school) is disrupted, physical and mental development is delayed. The presence of infantilism in a patient suggests an early onset of the disease. Attacks are manifested by a variety of symptoms: depressive and manic states, obsession, delirium, hallucinations, agitation, foolishness. However, the attacks themselves are less acute than in intermittent schizophrenia, and after leaving the attack, the patient remains with individual symptoms of the disease, that is, he does not fully recover, which requires the appointment of constant maintenance therapy. From attack to attack, the patient more and more reveals a flattening of the emotional-volitional sphere. With fur-like schizophrenia, the attacks are emotionally colored, delusional ideas are not systematized. Sometimes fur-like schizophrenia can go into a continuous course.

Treatment, depending on the condition of the patient, is carried out on an outpatient or inpatient basis. Currently, various and quite effective means of treating patients with schizophrenia have been developed. About 40% of patients who have undergone treatment are discharged in good condition and return to their previous place of work. Outpatient care is provided in a psycho-neurological dispensary, where patients are treated during minor exacerbations, and are also observed during remission. Dispensaries usually have medical and labor workshops in which patients with II and III groups of disability can work. This helps them adapt in life and benefit society.

Acute psychotic states in schizophrenia are usually treated in a hospital setting. These are the cases when the patient is a danger to himself (depression with suicidal ideation, refusal to write, delirium) and others (acute agitation, acute delusions of persecution, ordering "voices", etc.). The hospital provides supervision and care for the sick. The choice of treatment method depends on the characteristics of psychopathological symptoms, the severity of the condition, previous therapy, drug tolerance and the physical condition of the patient. Acute conditions are stopped by intramuscular administration of antipsychotics (chlorpromazine, haloperidol, triftazine, etc.). Antidepressants (amitriptyline, melipramine) are prescribed for depression, antipsychotics are used to stop the manic state. In addition to psychotropic drugs, nootropics, vitamins, and physiotherapy are widely used. According to the indications, they are treated with insulin coma and electroconvulsive therapy.

Patients with schizophrenia are subject to psychiatric registration and constant monitoring in a neuropsychiatric dispensary. If signs of a deterioration in the mental state of the patient are found, it is necessary to refer the patient to a psychiatrist for a consultation to correct the ongoing treatment. Of great importance is the organization of patients' free time - occupational therapy, satisfaction of cultural needs, walks. Psychotherapy, mainly of an explanatory nature, is carried out by patients during the recovery period, before discharge, and also during outpatient observation. It is also necessary to conduct conversations with relatives, family members of the patient in order to create a favorable family climate after the patient is discharged from the hospital.

Neither the patient nor the relatives should be afraid of the maintenance therapy prescribed by the doctor, since most drugs have practically no side effects, and if they exist, the doctor informs about this and gives appropriate recommendations. It is well known that for many diseases, such as diabetes, hypertension, thyroid diseases, etc., patients have been taking medications for many years, and sometimes for their entire lives, in order to maintain their physical condition. If there is a need for long-term maintenance therapy for schizophrenia, this should not be feared or ashamed. You need to carefully monitor your condition and inform your doctor about changes in it in order to timely adjust treatment.

Alarming in terms of exacerbation of the disease are usually symptoms such as sleep disturbances, refusal to eat, anxiety and fear, suspicion, unreasonable decrease or increase in mood. In women, such phenomena usually occur before menstruation, which requires additional treatment.

The prognosis depends not only on the type of course of the disease, but also on the timeliness and adequacy of treatment, as well as the effectiveness of rehabilitation measures.

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paroxysmal schizophrenia

In preschool children, in the clinical picture of an attack of schizophrenia, the leading syndrome is fear, usually combined with sensory and motor disorders due to external harm (fear, infection, head trauma). The manifestation of the disease is growing rapidly. Emotional tension quickly builds up, fear that something bad is about to happen. The child hides, covers himself with a blanket, becomes silent, fences himself off from the environment. Duration from several days to 2-3 weeks. Then it calms down and remission (recovery) occurs. Lasts from several months to several years.

Attacks of schizophrenia in children of preschool and preschool age are also manifested in the form of motor excitation, as well as psychopathic states (fear, obsessions).

Affective disorders always predominate. First of all, expressed fear, which is accompanied by hallucinations. Therefore, the presence of fear in preschool age can be considered as the beginning of many more complex affective (emotional) disorders.

The plot of fear initially reflects the content of the traumatized situation. At the same time, children do not seek help from others, they are reluctant to talk about the content of fear, about themselves. Each such attack has an impact on the personality. Often patients become more selfish, indifferent. Between patients and relatives there is a relationship without deep affection. The richness of the surrounding life is perceived by them insufficiently and adequately, the world narrows and is limited to the sphere of selfish experiences (indifference, suspicion, incredulity).

The concept of remission after an attack of schizophrenia can be viewed in different ways. This may be a recovery or a weakening of the course of the process. The second type of remission and the subsequent state, depending on working capacity, emotional safety, can be represented as four degrees of defect: Practical recovery: residual effects in patients are either completely absent or very insignificant, which do not prevent full working capacity and socialization. Such patients can work, study and others consider them healthy.

Remission with a slight defect: patients remain functional and social, but on a smaller scale. They may study in mass or special schools. They do not get along in the team, such children are considered not sick, but difficult to educate.

Sharp expressiveness of the residual phenomena: patients are disabled. They cannot attend a mass school, some have a tendency to antisocial behavior. But under favorable conditions, they can master light work.

Severe defect: patients do not serve themselves, they need constant care and supervision. Complete loss of performance.

2.5 Mental disorders due to intoxication associated with the use of psychoactive substances

Substance abuse is called drug addiction: cocaine, opium, cannabis, alcohol, nicotine.

Drugs are easily addicted, in which a person cannot do without them, becomes dependent on them and is often unable to continue working until he uses the narcotic substance.

Modern psychiatry considers drug addiction (in a broad sense) as a consequence of addictive behavior.

When using drugs, there is an escape from reality by artificially changing the mental state, i.e. there is a chemical addiction.

In addition to chemical addiction (alcohol, drug addiction), there are non-chemical forms of addictive behavior: starvation, gambling, love, sexual addiction, workaholism. Under the action of narcotic substances, 2 phases are distinguished:

Excitations: elevated mood, there is a feeling that an increase in efficiency, everything seems to be easily achievable.

Depression: when the mood is lowered, work capacity drops sharply, movements become slow, motionless, irresistible drowsiness sets in and the person falls into a heavy narcotic sleep.

At the end of the action of the drug, withdrawal occurs. The mood goes down, everything seems gloomy, irritating, a neuro-vegetative disorder appears, the pulse rhythm is disturbed, cold sweat appears, the mouth dries, there is a sleep disorder. If the attraction to the drug becomes irresistible, the melancholy grows, becomes unbearable and thoughts are occupied with one thing: to get a saving remedy at any cost.

Pathological substance use is divided into 2 main groups:

Substance abuse

Substance Dependence

There are 3 main drug syndromes.

1. Drug intoxication syndrome (acute intoxication)

2. Big drug addiction syndrome (Includes a change in reactivity, the disappearance of protective features, a change in tolerance, forms of consumption, forms of intoxication. A syndrome of physical and mental dependence appears, withdrawal syndrome.)

3. Syndrome of consequences of chronic intoxication

paroxysmal schizophrenia

Acute polymorphic schizophrenia (acute polymorphic syndrome with paroxysmal schizophrenia, according to ICD-10 - “acute polymorphic mental disorder with symptoms of schizophrenia”, according to the American classification - “schizophreniform disorder”) develops within a few days and lasts for several weeks. Against the background of insomnia, anxiety, confusion, misunderstanding of what is happening, extreme emotional lability manifests itself: for no reason, fear alternates with euphoric ecstasy, crying and complaints - with malicious aggression. Occasionally there are hallucinations (often auditory, verbal), pseudohallucinations (“voice inside the head”), mental automatisms (“thoughts made” by someone, the sound of one’s own thoughts in the head with the feeling that they are heard by everyone - the openness of thoughts). Olfactory hallucinations are often distinguished by unusual odors (“smells like radioactive dust”) or bizarre labeling (“blue-green odors”).

Crazy statements are fragmentary, do not add up to a certain system, one crazy idea replaces another and can be immediately forgotten. Usually, crazy statements are provoked by the situation: they take blood from a patient for analysis - they want to kill him, releasing all the blood, or infect him with AIDS. A vent in the wall that caught my eye suggests a listening device. The announcer on the radio changes the intonation of the voice and thus gives the patient conditional signals. The delusion of staging is especially characteristic: the hospital is mistaken for a prison, where everyone “depicts the sick”, or for a secret institution where experiments are performed on people. Often a symbolic interpretation of everything that happens. For example, the patient was put on a bed in the corner - this means that in life he will be “driven into a corner”.

In many cases, even without treatment, an attack of acute polymorphic schizophrenia ends in recovery. Therefore, in American psychiatry, the opinion prevails that the diagnosis of schizophrenia in such patients can only be made if the psychosis drags on for several months. During this time, acute polymorphic schizophrenia is usually replaced by a paranoid, simple or hebephrenic form.

Febrile schizophrenia (hypertoxic schizophrenia; in the old manuals “acute delirium”, delirium acutum) is also not recognized by everyone as a form of schizophrenia. It is assumed that this is a special mental illness, a consequence of infectious-toxic damage to the brain or hypothetical autointoxication or a drop in the immune and other protective reactions of the body, which makes banal infections become toxic.

The onset is sudden, the disease can unfold in one to two days. A semi-conscious or unconscious state develops (stupor, stupor, coma), combined with motor excitation in bed, reminiscent of choreiform hyperkinesis (sweeping movements of the arms, legs, grimaces or continuous removal of invisible specks from the body). Patients make inarticulate sounds. Sometimes it is possible to get 1-2 answers to simple questions, more often it is impossible to make contact.

The physical condition is severe. Body temperature reaches 40 ° C and above. The skin becomes icteric, petechiae and bruising may appear on it. The pulse is frequent and weak, often there are collapses. Usually associated with pneumonia. Even with intensive treatment, mortality reaches 20%. Pathological anatomical examination reveals swelling of the brain, petechial hemorrhages in internal organs, myocardial dystrophy, liver, kidneys. In more favorable cases, the described condition is replaced by other syndromes (stupor, amental syndrome, mania, etc.) or recovery occurs after severe prolonged asthenia.

- is characterized, according to Russian researchers, by psychotic attacks of different duration (from several days to a number of years), with various psychopathologies (affective, delusional, hallucinatory, paraphrenic, catatonic, oneiroid disorders) and long-term remissions of a sufficiently high quality, close to intermissions or identical to them . The number of attacks can reach 3-4 or more, a third of patients have only one attack throughout their lives. In some patients, the seizures proceed in the same way, that is, according to the type of cliche, in other patients there are different types of seizures, the clinical picture of which can be used to judge the dynamics of the process as a whole. If their clinical structure is aggravated from one attack to another, then a tendency to progression should be assumed, if the reverse picture is observed, then the hypothesis of a tendency to the reverse development of the process and, accordingly, a favorable prognosis of the disease seems more justified. Noteworthy is the fact that it is the first attack that is the most severe - usually it is an attack of oneiroid catatonia. The initial period of the disease lasts up to several months. At this time, asthenic, affective, neurosis-like disorders are observed. The onset of the manifest stage refers to the age of 17 to 25 years. The psychotic attacks arising at this time can stop in any of its phases, without reaching their culmination, that is, oneiroid catatonia. These are attacks of acute paraphrenia, acute fantastic delusions (with delusions of staging, intermetamorphosis, antagonistic delusions, delusions of negative and positive twins), acute hallucinatory-paranoid, affective-delusional or affective-hallucinatory syndromes, acute paranoia or affective disorder. Affective disturbances tend to persist in the clinical pattern of more severe attacks of illness. Attacks with depressive-paranoid symptoms are most often prognostically unfavorable, indicating the possibility of their long course. Affective seizures ("circular schizophrenia") are atypical, they rarely present the classic triad of signs of an affective disorder, but quite often there are mixed states, dual phases. In the residual period of the disease, deficiency symptoms may not be detected at all, but in some cases, as the disease moves from one attack to another, it gradually accumulates. In some cases, there is a transition from periodic to fur-like schizophrenia. Treatment of the disease is reduced to the relief of psychotic attacks using mainly drugs with a sedative effect (tizercin, azaleptin, chlorprothixene, phenazepam), antidepressants and antimanic drugs. Seizure prevention is recommended with carbamazepine, verapamil. Synonym: Recurrent schizophrenia. In the ICD-10, this form of schizophrenia is coded by different headings, including included in schizoaffective psychosis.

Other related news:

"F06.3" Organic mood disorders (affective)

"F34" Persistent (chronic) mood disorders (affective disorders)

"F38.1" Other recurrent mood disorders (affective disorders)

F19.0xx Acute intoxication due to the simultaneous use of several drugs and the use of other psychoactive substances

F23.3 Other acute predominantly delusional psychotic disorders

F23.3x Other acute predominantly delusional psychotic disorders

F31.3 Bipolar affective disorder current episode of moderate or mild depression.

F34.8 Other persistent (chronic) mood disorders (affective disorders)

F34.8 Other chronic (affective) mood disorders

People with schizophrenia often face negative social attitudes because they there is a prejudice that a schizophrenic is a potential threat to society. However, among people with such a diagnosis, one can meet truly talented, creative and brilliant personalities.

Schizophrenia in Greek means "to split the soul", this concept was introduced in 1911 by Erwin Bleuler. Prior to this, the term "premature dementia" (Dementia praecox) was used.
Schizophrenia is a chronic, endogenous mental illness, which is characterized by specific fundamental disorders of thinking, perception, emotional sphere, as well as progressive negative personality changes. Typical symptoms of this disease are delusions, hallucinations, but the intellect does not suffer from schizophrenia.
Schizophrenia has a long course, which goes through certain stages and has a number of patterns, syndromes and symptoms.

Signs and symptoms of schizophrenia

Auditory hallucinations, paranoid or fantastic delusions (productive symptoms);
social dysfunction, apathy, abulia, low performance (negative symptoms);
Violations of thinking, attention, perception (disorders of the cognitive sphere).

Schizophrenia usually begins in adolescence, or a little later, according to recent studies, the disease is preceded by prodromal (pre-debut) symptoms, which can manifest as irritability, a desire for isolation, a feeling of hostility towards others, which subsequently turn into short-term psychotic symptoms.
Prodromal signs may appear two and a half years, and in some cases even earlier, before the appearance of obvious signs of the disease.

Positive and negative symptoms

Positive or productive symptoms:

delusions of persecution, delusions of influence;
auditory hallucinations;
thinking disorders;
catatonia - lack of motor reaction, "freezing" in one position for a long time;
hebephrenia - unnatural, foolish behavior, antics.

Negative or deficiency symptoms:

schism - splitting, splitting of psychological processes at the emotional, volitional and cognitive levels, disintegration.
reasoning - idle talk, lack of activity, which the patient constantly talks about;
apathy - a decrease in affect, a progressive loss of emotionality;
deterioration of speech abilities, ambiguity of the content of speech;
loss of the ability to enjoy (anhedonia)
loss of motivation (aboulia);
parabulia - the preservation of emotions in a specific "reserve" zone, interest in some narrow, isolated area to the detriment of other activities, for example, counting the number of a certain letter in a literary work, collecting excrement, etc.

A separate group of symptoms is also distinguished, which includes disorganization symptoms - chaotic speech, behavior and thinking (disorganization syndrome).

Schneiderian symptoms of the first rank

Kurt Schneider, a German psychiatrist (1887-1967), identified a number of symptoms that distinguish schizophrenia from other mental disorders and illnesses.

The sound of thoughts, pseudo-hallucinations;
Sensation of arguing voices in head;
Hallucinations with comments;
Feeling that the patient's movements are under the control of someone from outside, somatic passivity.
Thoughts are “invested” and “stealed”, interruption and lethargy, “blockage” of thoughts.
Feeling the radio in the head, the availability of thoughts to others.
Awareness of feelings, sensations, thoughts in the head as alien, embedded from the outside, for example, the patient does not feel pain, but he is forced to experience it.
Delusions of perception - the patient interprets what is happening to him, based on his internal, usually symbolic, ideas.

Schizophrenia is characterized by blurring the lines between the awareness of one's "I" and "not me", the patient's inner world and the outside world.

Bleuler's tetrad

E. Bleiler identified a complex of 4 signs of schizophrenia that are characteristic of this disease:

Associative defect (alogia), violations of logical thinking;
A symptom of autism is immersion in one's inner world, a departure from external reality.
Ambivalence - duality, the appearance in the patient's mind of mutually exclusive emotions, attitudes, beliefs in relation to one object at the same time, for example, a feeling of love and hate, pleasure and displeasure, desire and unwillingness, etc.
Affective inadequacy - the appearance of unexpected and socially unacceptable emotional reactions in everyday life, for example, the manifestation of joy at a tragic moment.

Origin of schizophrenia

Disease prevalence

Both men and women suffer from schizophrenia, but in the latter, the disease begins on average 6 years later. In childhood, middle and old age, the disease occurs rarely, as a rule, the main symptoms appear from 20 to 30 years. Schizophrenia is more prone to urban residents and people with low incomes.
Schizophrenia is disabling and shortens lives by an average of 10 years, often due to suicide.
However, patients with schizophrenia are less susceptible to viral diseases, colds, tolerate cold well, and are more physically resilient. According to statistics, most potential patients are born in March-April.
Schizophrenia varies according to the type of course:

Continuous Progressive Schizophrenia
Paroxysmal
Paroxysmal-progredient - characterized by acute or subacute attacks and intervals between them. After such attacks, or "shifts" in the patient's psyche, irreversible changes remain that have a negative impact on his personality. "Shifts", from German called fur coats, gave the second name to this form of the disease - fur-like schizophrenia.
recurrent (periodic)

Stages of the course of schizophrenia

Schizophrenia by rate of development(progression), excluding the recurrent form, is subdivided into:

Malignant (rapidly progressive) - occurs at the age of 2 to 16 years, the initial period lasts about a year, the manifest - up to 4 years. Positive symptoms appear immediately and very brightly, later there is a syndrome of apathy, abulia, which can be overcome only in case of severe stress. Treatment is symptomatic;
Paranoid (medium progredient) - The disease manifests itself at the age of 20-45 years, it is preceded by an initial period (lasting about 5 years). The manifest period is characterized by either delusions or hallucinations, the duration of this period is about 20 years. At the final stage - fragmentation delirium, speech is preserved. With appropriate therapy, the likelihood of remission is quite high. In continuous-progressive schizophrenia, symptoms such as delusions and hallucinations are more pronounced than affective symptoms, and in paroxysmal, on the contrary, disorders of the emotional-volitional sphere prevail. The need for inpatient treatment in the case of continuously progressive schizophrenia is 2-3 times a year, and in paroxysmal - approximately 1 time in 3 years, and remissions in this form of the disease are more stable and can be spontaneous.
Sluggish (low-progressive). The disease manifests itself at the age of 16 to 25 years, the boundaries between the initial, initial and manifest periods are fuzzy. The disease manifests itself as neurosis-like states, schizophrenic psychopathization, despite such symptoms, a person with this form of schizophrenia can lead a normal life: have a family, friends, work, but the disease as a whole has a negative impact on the quality of his life.

Diagnosis of schizophrenia

Schizophrenia is diagnosed after revealing a number of productive symptoms of the disease, their combination with negative disorders of the emotional-volitional sphere of the personality, which lead to difficulties in communication for at least 6 months. Particular attention in the diagnosis of schizophrenia is given to such symptoms of productive disorders as the impact on the patient's thoughts, schism, catatonic syndrome. Among the negative symptoms, it is important for diagnosis to identify the loss of emotionality, unmotivated aggression, alienation, coldness. The most pronounced symptoms in schizophrenia are "echo of thoughts", inadequate delusional ideas, chronic hallucinations (at least a month), catatonia.
Diagnosis of paranoid schizophrenia:

pronounced phenomena of delusions of persecution, thought transfer, paranoid delusions, hallucinations.
catatonic disorders, decreased affect, speech disorders are mild.

Diagnosis of hebephrenic form of schizophrenia:

Pronounced decrease in affect
Persistent inadequacy of emotional response
disorientation, disorganized behavior;
Severe cognitive impairment, incoherent speech.

Diagnosis of catatonic schizophrenia:
Combines the general symptoms of schizophrenia and one of the following symptoms:

stupor, mutism;
inadequate motor activity;
stereotypical movements;
negativism - unmotivated opposition to others;
rigidity;
freezing in a position given from the outside ("wax flexibility");
automatism, following external instructions.

In cases where the patient's condition does not have specific criteria inherent in individual forms of schizophrenia, or the symptoms are characteristic of several forms, and in general his condition is within the framework of general symptoms, an undifferentiated form of schizophrenia is diagnosed.
The diagnosis of post-schizophrenic depression is made:

the patient had symptoms common to schizophrenia during the year;
preservation for a long time of at least one symptom;
the severity of the depressive syndrome should be sufficiently pronounced to correspond to the symptoms of a mild depressive episode (F32.0).

The diagnosis of the residual form of schizophrenia is made:
If the condition in the past included symptoms common to schizophrenia that were not detected at the time of the examination, as well as the presence of at least 4 negative signs:

lethargy, decreased activity;
pronounced decrease in affect;
passivity, lack of initiative;
poverty of speech;
inexpressiveness, poverty of facial expressions, gestures, an absent look, etc.;
autism, loss of interest in social life, the outside world.

The diagnosis of a simple form of schizophrenia is made:

Pronounced changes in personality traits, loss of interests, productivity of social life, alienation, withdrawal from the outside world;
The appearance of apathy, a decrease in affect, a weakening of the emotional-volitional sphere, lack of initiative, loss of motivation, impoverishment of non-verbal speech.
The condition always does not correspond to the characteristic features for paranoid, hebephrenic, catatonic and undifferentiated schizophrenia (F20 / 0-3).
Symptoms of dementia or organic brain damage (FO) are excluded.

You must have all of the above symptoms, progressing for at least a year.

To confirm the diagnosis, it is necessary to conclude a pathopsychological study, as well as the result of clinical and genetic data on the presence of schizophrenia in the patient's parents and close relatives.

Pathopsychological tests in schizophrenia

Psychological examination of patients with schizophrenia is carried out mainly using the method of conversation, which allows you to identify the logical inconsistency of thinking and the disorder of associative processes.
It is possible to reveal the formality of judgments, misunderstanding of the figurative meaning, manifested as a set of words, logically unrelated thoughts, when interpreting proverbs and sayings by the patient.
Also well informative, in the diagnosis of schizophrenia, is a test for the exclusion of one superfluous one from the conceptual series - the patient either excludes the concept according to one sense he knows, or it is completely difficult to exclude anything.

Schizophrenia Predictions

About 40 factors that determine the prognosis of the course of schizophrenia have been identified. So, male sex, schizophrenia in close relatives, mild onset of the disease, pronounced hallucinatory syndrome, "causeless" onset of the disease are unfavorable factors, while female sex, absence of organic concomitant disorders, acute onset, affective form, good response on primary therapy are favorable factors.
According to statistics, 10-12 people out of 100 who suffer from schizophrenia die as a result of suicide, and about 40 people attempt suicide. The main risk factors for suicide in schizophrenia are:

High intelligence;
Male;
Previous suicide attempts;
Young age;
Use of drugs, alcohol;
Hallucinations that command you to do certain things;
Ineffective doses of medications;
The first post-stationary months;
Problems in the patient's social life.

Sluggish schizophrenia

About half of patients suffer from schizophrenia in a sluggish form, i. the disease is a neurotic personality disorder, with symptoms such as asthenia, perceptual disturbances, depersonalization. There is no progression and a pronounced form of manifestation. In psychiatry, the following names are also accepted for this form of the disease: mild schizophrenia, non-psychotic, microprocessive, hidden, rudimentary, amortized, etc.
Sluggish schizophrenia is characterized by a long-term development of the stages of the disease, possible stabilization with a weakening of negative symptoms, long-term remissions, and a subclinical course. Sometimes a new development of the disease is possible at the involutionary age (45-55 years).

Periodic (recurrent) schizophrenia

This form of schizophrenia is complex in its form and symptoms, it is difficult to diagnose, according to the International Classification of Diseases (ICD) it is listed as schizoaffective disorder.
Stages of occurrence of recurrent schizophrenia:

It occurs in adolescence, at the initial stage, the occurrence of exaggerated fears, subdepression, asthenia, as well as somatic disorders, constipation, refusal to eat, etc. is characteristic. Duration is about 1-3 months.
At the next stage of the development of the disease, a delusional affect, an acute paranoid syndrome appear, changes in self-awareness, depersonalization progress.
Pronounced progress of affective-delusional depersonalization and derealization, automatism, false recognition, a symptom of twins appear.
At this stage, there is a paraphrenic syndrome, delusions of grandeur, delusions of protection, the perception of the patient at this stage is fantastic, affective-delusional depersonalization and derealization are aggravated.
The stage of illusory-fantastic derealization and depersonalization.
The stage of oneiric stupefaction of consciousness - the perception of reality is completely broken, it is impossible to enter into interaction with the patient.
Amentative-like disturbance of consciousness, confusion, catatonia, fever. At this stage, the prognosis is extremely unfavorable.

It should be noted that these stages may represent a separate form of the disease. In most cases, the patient's condition worsens with each attack, but stabilization is possible at some stage.

Treatment of schizophrenia

Currently, there is no single concept for the treatment of schizophrenia, this is due, on the one hand, to the fact that there is no consensus regarding the very definition of schizophrenia, but on the other hand, a number of criteria for successful remission have been developed that are used in research and clinical practice. Currently, therapy is mainly aimed at relieving symptoms and improving the quality of life of patients.
Common therapies include biological therapies such as Shock Therapy, Insulin Coma Therapy, Convulsive Therapy (currently not used), Electroconvulsive Therapy, Diet Relief Therapy, etc.
In the medical treatment of schizophrenia, the following drugs are used: antipsychotics, mood stabilizers, anxiolytics, nootropics, antidepressants, psychostimulants.
The second group of methods for treating schizophrenia includes methods of social therapy, i.e. psychotherapy and methods of social rehabilitation.

Psychotherapy is widely used in the treatment of schizophrenia, it is aimed not only at correcting symptoms, but also at rehabilitating patients in society.

The following areas are most successful in the treatment of schizophrenia:

Cognitive-behavioral therapy - positively affects self-esteem, awareness of one's condition and one's function in the patient's society, reduces symptoms.
Cognitive training - this method is based on neuropsychological rehabilitation techniques aimed at combating disorders of the cognitive (mental) sphere.
Family therapy - is aimed at the patient's family, has a beneficial effect not only on the patient, but also helps his loved ones.
Art therapy has not shown effective results in the treatment of schizophrenia.

Hospitalization

Due to the fact that patients with schizophrenia, as a rule, are not aware of their illness, in conditions that threaten the life and health of both the patient and others, the patient needs hospitalization, in some cases compulsory.
If the patient's condition is characterized by the following symptoms:

sudden weight loss;
the presence of imperative hallucinations,
suicide attempts or suicidal thoughts;
unmotivated aggression;
psychomotor agitation, he needs treatment in a hospital.

Article 29 of the Law of the Russian Federation (1992) "On psychiatric care and guarantees of the rights of citizens in its provision" clearly regulates the grounds for involuntary hospitalization in a psychiatric hospital, namely:
"A person suffering from a mental disorder may be hospitalized in a psychiatric hospital without his consent or without the consent of his legal representative until the decision of the judge, if his examination or treatment is possible only in hospital conditions, and the mental disorder is severe and causes: danger to yourself or others, or his helplessness, that is, the inability to independently meet the basic needs of life, or significant harm to his health. due to the deterioration of the mental state, if the person is left without psychiatric care".

Treatment during remission

It is impossible to completely recover from schizophrenia, but with effective treatment it is possible to achieve long-term remission and stabilization, therefore, during the period of remission, despite the apparent recovery, it is necessary to continue the course of maintenance therapy. Otherwise, the disease will worsen again.
The disease is in remission, if there is no delirium, hallucinations, suicidal thoughts stop, aggressive behavior disappears, the patient, as far as possible, socially adapts.

In the process of successful treatment, the patient's relatives play a huge role, because. the effectiveness of therapy depends on their successful cooperation with a psychiatrist.