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ABOUT SCHIZOPHRENIA - Illness progression

Clinical Picture
Causes
Illness progression
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 Illness Progression

After the symptoms subside, the further develop of schizophrenic illness is not consistent. In about one quarter of the cases, the patient is (nearly) completely healed after the first incidence. With the so-called episodic progression, the illness recurs - and the time span and frequency of the occurrences vary. The second psychotic episode can progress in a completely different manner. Each incident can leave behind a residual condition such as a personality change, which in mild cases does not impact the ability to work or adjust (social remission). About one third of those who suffer from the illness has a markedly adverse, chronic progression. Each new episode of the illness leaves behind a permanent change in the personality and extends to the loss of the ability to adapt socially and hospitalization. Even in cases of a chronic-progressive course of the disease schizophrenia there can, in the future, be spontaneous improvements or improvements due to therapy. A relapse can occur months or years later, in some cases even decades later. The results from three progression studies show that in two thirds of the cases the disease progression is positive or very positive. Since that time, the treatments have been decisively improved so that the chances for a positive long-term progression of schizophrenic illness are even better.

Sub-forms of schizophrenia
  • enduring delusions (for example delusions of being followed, poisoned, impaired or relational delusions)
  • usually accompanied by acoustic hallucinations and perceptual disorders
  • in acute states, partial thought disorders
  • frequently fearful and distrustful
  • disturbances in motor skills, for example motor activity that is not caused by external stimulation, apparently inane motor activity, diminished reaction to environment or reduced spontaneous movement and activity
  • physical forced postures and positions that often remain over a long period of time
  • episodes of agitated states or dreamlike states with animated hallucinations
  • a lack of emotional responsiveness, listlessness, absent-minded thinking, circuitous speaking
  • fragmentary delusional experiences and hallucinations
  • flat, inappropriate mood, often accompanied by giggling or an introverted smiling
  • frequent grimacing, unnaturally-affected conducted movements, grimaces, hypochondriatic complaints or constantly repeated comments
  • relative early onset (between 15-25. years of age), negative symptoms develop quickly, generally poor prognosis. Those with shy or loner personalities before the onset of the illness tend to, after the development of the disease, to isolate themselves
Possible consequences of the illness

In daily life, protracted phases of suffering predominate. It is not unusual that serious conflicts arise, friendships are ended, the afflicted retreats from his or her social circle, withdraws from cliques and groups in which he or she had long been active. The afflicted may loose his or her job and degenerate. Often, a diagnosis and psychiatric treatment is first possible when normal psychological coping efforts have failed, the situation peaks into a crisis situation, and the afflicted has a breakdown. When we use the word schizophrenia in connection with a particular person, we are using a scientific abstraction that is derived from the particular behavior and experiences of that person. When those behaviors are severe, his or her personality seems changed to us. All the same, the person remains a unique being that happens to be suffering from schizophrenia. He or she remains so because the principle characteristic of schizophrenia insists that the healthy person remain within the schizophrenic. The diagnosis "Schizophrenia" is not a label for persons who behave strangely.

Composed by the Anti-Stigma-Workgroup of the LMU in association with BASTA - the association for the mentally ill.
 
 
  © 2006 BASTA