Schizophrenia is one of the endogenous psychoses and is a serious mental illness. Worldwide, around 45 million people suffer from the disease.
There are different forms of schizophrenia:
- Most often, the paranoid hallucinatory form occurs with the Wahnerleben, the hallucinations and the ego disorders.
- This is followed by catatonic schizophrenia with arousal, rigid posture, or posture and speech stereotypes.
- Likewise the hebephrenic schizophrenia beginning in adolescence, a flat, inappropriate, cheerful-silly affect, disorder of thought (disorderly thinking, indeterminate or bizarre language) and drive disorders (apathetic or unabashed behavior).
- The undifferentiated schizophrenia, in which no clear assignment to the above forms is possible, is another form.
- There is also the schizophrenic residual, in which schizophrenic symptoms persist after at least one schizophrenic stage.
Negative and positive symptoms of schizophrenia
The different forms of schizophrenia show different symptoms that facilitate the association. One speaks of negative and positive symptoms of schizophrenia. They can coexist, but often during the acute phase of the disease, positive symptoms that are negative between episodes predominate.
- Negative symptoms include impoverishment of language, facial expressions and gestures, an apathetic attitude, the loss of the ability to experience pleasure, attention deficit and social withdrawal.
- Among the positive symptoms include hallucinations, a delusion, the ego disorders such as mental noise and a bizarre behavior.
Often it comes even before the first phase of the disease to a negative symptoms in which an extraordinary behavior with social withdrawal occurs, for example, suddenly books are read on unusual topics, in adolescents this phase is often accompanied by a performance kink.
Course and prognosis
Schizophrenias can be different: schizophrenic psychosis can be acute and dramatic, or creeping and barely perceptible to outsiders. They can remain a one-time episode or determine life at shorter or longer intervals. Most often it comes after a disease phase to a cure, but it is also possible a wave-shaped, chronic disease progression and progressing events (least often).
A good prognosis for married patients is that stress or acute, severe life events have led to a disease outbreak, and patients with rare and short disease phases who show an acute onset of illness and for whom the early treatment of the psychotic symptoms is successful.
By contrast, divorced or isolated male patients in social isolation with long and frequent disease phases and insidious onset of disease have a poor prognosis. Even a negative symptoms, auditory hallucinations and delusions that remain pharmacologically untreated for a long time, worsen the prognosis.
Meaning of neuroleptics in schizophrenia
Particularly important is the sufficiently long and properly used drug therapy with neuroleptics, also known as antipsychotics. Sixty to eighty percent of sufferers relapse within two years of their first hospital stay. However, if you give neuroleptics long enough, you can reduce this rate of relapse by at least 50 percent, that is, you should give the neuroleptics for at least a year, even if the schizophrenia symptoms completely disappeared.
A healthy relationship between the patient and the doctor helps the patient to understand his illness - both the origins, the symptoms, and the methods of treatment, as well as the individual options he has to prevent a relapse.
Other treatment of schizophrenia
Furthermore, the drug therapy also includes the use of atypical antipsychotics. Compared with typical neuroleptics, these often have a more favorable effect on subjective mood, neurophysiological performance, communication quality and thus the prevention of a relapse.
Modern treatment concepts also combine drug therapy with psychotherapy, trauma and family therapy for patients, relatives and close caregivers. Psychoeducation also plays a major role here. The knowledge gained facilitates the treatment of the illness and contributes to the relaxation in the families. In addition, the patient's willingness to therapy can increase significantly and an approaching relapse can be treated in good time.
Particularly noteworthy is a contingency plan that includes the patient's individual early symptoms such as restlessness, nervousness and tension, insomnia, difficulty in working, feeling overwhelmed, impaired concentration or memory, and social withdrawal. The plan determines what the patient can do with relatives or friends, if such symptoms occur, for example, increase the drug dose, see the doctor.
With these measures, which include ergo and occupational therapy, vocational rehabilitation and assisted living, up to 60 percent of patients can be permanently reintegrated (40 percent in their old job, 20 percent below the previous level), only 10 percent of those Patients become permanently disabled.