What are the signs of a latent form of schizophrenia? Forms of schizophrenia Which form of schizophrenia is most difficult to recognize.

Speaking professionally, the term " mild form' is not quite correct. This disease can change a person's personality beyond recognition, even in its mildest manifestations. Nevertheless, this phrase can often be found in the anamnesis of patients in neuropsychiatric clinics. Therefore, it is necessary to explain what is meant by it.

Place in the modern classification of diseases

In the previous international classification of diseases (ICD-9), there was a definition of indolent (or low-progressive) schizophrenia, which in the current ICD-10 was replaced by the term "schizotypal disorder". It includes neurosis-like, psychopathic, latent schizophrenia and schizotypal personality disorder. Moreover, the latter term is more often used in the English-language psychiatric literature than in the domestic one.

Diagnosis of schizotypal disorder or mild form of schizophrenia a psychiatrist can put a patient when he has some characteristic symptoms diseases. However, in terms of their totality and degree of manifestation, they are not enough to make a diagnosis of schizophrenia.

As a rule, such patients do not have pronounced delusions and hallucinations, or they are rudimentary and are not decisive in the clinical picture of the disease. There is also no progression of the course of the disease, which is characteristic of more severe forms of schizophrenia, and such pronounced deficient changes are not formed.

Symptoms

In order to make a diagnosis such as mild form of schizophrenia, the physician must verify that the patient has had 3 or 4 of the following symptoms for at least two years:

• Strangeness, eccentricity in behavior and appearance.
• Views that do not correspond to the dominant culture and religion.
• A tendency towards symbolic or magical thinking.
• Thought disorders are not characterized by pronounced structural changes, but a tendency to fruitless reasoning (reasoning), pretentiousness, and stereotyping prevails.
• Scarcity of emotions, inadequate emotional reactions, self-isolation from others.
• Depersonalization and derealization phenomena.
• Obsessive states, which the patient does not try to resist.
• Dysmorphophobic (associated with the belief in the presence of a disfiguring physical defect), hypochondriacal, aggressive and sexual thoughts predominate.
• Suspicion (up to).
• Passivity, lack of initiative, lack of a fruitful result from mental activity.

Brad, at mild form of schizophrenia may appear sporadically in a rudimentary form and do not reach the signs of a clinically delineated psychosis. Sometimes these symptoms may precede the development of severe forms of schizophrenia, most often paranoid.

The outstanding Swiss psychiatrist Eugen Bleiler, who introduced the term “mind splitting” into psychiatric science, believed that there were much more mild and even latent forms of schizophrenia than clearly clinically defined forms. On closer examination, many neurotics might fall under this diagnosis. This opinion also prevailed in Soviet psychiatry, however, this theory is now being questioned.

Distinguishing a psychopathic schizophrenic from a patient suffering from schizoid or paranoid personality disorder can be quite difficult. That is, to the diagnosis of the schizophrenic spectrum, including mild form schizophrenia, must be approached carefully.

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General characteristics of schizophrenia

Schizophrenia is a disease that belongs to the group of endogenous psychoses, since its causes are due to various changes in the functioning of the body, that is, they are not associated with any external factors. This means that the symptoms of schizophrenia do not occur in response to external stimuli(as in neurosis, hysteria, psychological complexes, etc.), but on their own. This is the fundamental difference between schizophrenia and other mental disorders.

At its core, it is a chronic disease in which a disorder of thinking and perception of any phenomena of the surrounding world develops against the background of a preserved level of intelligence. That is, a person with schizophrenia is not necessarily mentally retarded, his intelligence, like that of all other people, can be low, medium, high, and even very high. Moreover, in history there are many examples of brilliant people who suffered from schizophrenia, for example, Bobby Fischer - world chess champion, mathematician John Nash, who received Nobel Prize etc. The story of John Nash's life and illness was brilliantly told in A Beautiful Mind.

That is, schizophrenia is not dementia and a simple abnormality, but a specific, completely special disorder thinking and perception. The term "schizophrenia" itself consists of two words: schizo - split and phrenia - mind, reason. The final translation of the term into Russian may sound like "split consciousness" or "split consciousness". That is, schizophrenia is when a person has a normal memory and intellect, all his senses (vision, hearing, smell, taste and touch) work correctly, even the brain perceives all information about environment the way it should be, but the consciousness (the cerebral cortex) processes all this data incorrectly.

For example, human eyes see the green leaves of trees. This picture is transmitted to the brain, assimilated by it and transmitted to the cortex, where the process of comprehending the received information takes place. As a result, a normal person, having received information about green leaves on a tree, comprehends it and concludes that the tree is alive, it is summer outside, there is a shadow under the crown, etc. And with schizophrenia, a person is not able to comprehend information about green leaves on a tree, in accordance with the normal laws inherent in our world. This means that when he sees green leaves, he will think that someone is painting them, or that this is some kind of signal for aliens, or that he needs to pick them all, etc. Thus, it is obvious that in schizophrenia there is a disorder of consciousness, which is not able to form an objective picture from the available information based on the laws of our world. As a result, a person has a distorted picture of the world, created precisely by his consciousness from the initially correct signals received by the brain from the senses.

It is because of such a specific impairment of consciousness, when a person has both knowledge, and ideas, and correct information from the senses, but the final conclusion is made with the chaotic use of their functionals, the disease was called schizophrenia, that is, the splitting of consciousness.

Schizophrenia - symptoms and signs

Indicating the signs and symptoms of schizophrenia, we will not only list them, but also explain in detail, including examples, what exactly is meant by this or that formulation, since for a person far from psychiatry, it is precisely the correct understanding of the specific terms used to designate symptoms, is the cornerstone for getting an adequate idea of ​​the subject of the conversation.

First, you should know that schizophrenia is characterized by symptoms and signs. Symptoms are understood as strictly defined manifestations characteristic of the disease, such as delirium, hallucinations, etc. And signs of schizophrenia are four areas of human brain activity in which there are violations.

Signs of schizophrenia

So, the signs of schizophrenia include the following effects (Bluyler's tetrad, four A):

Associative defect - is expressed in the absence of logical thinking in the direction of any ultimate goal of reasoning or dialogue, as well as in the resulting poverty of speech, in which there are no additional, spontaneous components. Currently, this effect is called briefly - alogia. Let's consider this effect with an example in order to clearly understand what psychiatrists mean by this term.

So, imagine that a woman is riding a trolley bus and her friend enters at one of the stops. A conversation ensues. One of the women asks the other: "Where are you going?" The second replies: "I want to visit my sister, she is a little sick, I'm going to visit her." This is an example of a response normal person not suffering from schizophrenia. In this case, in the response of the second woman, the phrases “I want to visit my sister” and “she is a little sick” are examples of additional spontaneous speech components that were said in accordance with the logic of the discussion. That is, the only answer to the question of where she is going is the "to her sister" part. But the woman, logically thinking of other questions of the discussion, immediately answers why she is going to her sister (“I want to visit because she is sick”).

If the second woman to whom the question was addressed was a schizophrenic, then the dialogue would be as follows:
- Where are you driving?
- To Sister.
- Why?
- I want to visit.
Did something happen to her or just like that?
- It happened.
- What's happened? Something serious?
- Got sick.

Such a dialogue with monosyllabic and non-expanded answers is typical for the participants in the discussion, among whom one is ill with schizophrenia. That is, with schizophrenia, a person does not think out the following possible questions in accordance with the logic of the discussion and does not answer them immediately in one sentence, as if ahead of them, but gives monosyllabic answers that require further numerous clarifications.

Autism- is expressed in distraction from the real world around and immersion in one's inner world. A person's interests are sharply limited, he performs the same actions and does not respond to various stimuli from the outside world. In addition, a person does not interact with others and is not able to build normal communication.

Ambivalence - is expressed in the presence of completely opposite opinions, experiences and feelings regarding the same object or object. For example, in schizophrenia, a person may simultaneously love and hate ice cream, running, etc.

Depending on the nature of ambivalence, there are three types of it - emotional, volitional and intellectual. So, emotional ambivalence expressed in the simultaneous presence of an opposite feeling towards people, events or objects (for example, parents can love and hate children, etc.). Volitional ambivalence is expressed in the presence of endless hesitation when it is necessary to make a choice. Intellectual ambivalence consists in the presence of diametrically opposed and mutually exclusive ideas.

affective inadequacy - is expressed in a completely inadequate reaction to various events and actions. For example, when a person sees a drowning person, he laughs, and when he receives some kind of good news, he cries, etc. In general, affect is an external expression of an internal experience of mood. Accordingly, affective disorders are external manifestations that do not correspond to internal sensory experiences (fear, joy, sadness, pain, happiness, etc.), such as: laughter in response to the experience of fear, fun in grief, etc.

These pathological effects are signs of schizophrenia and cause changes in the personality of a person who becomes unsociable, withdrawn, loses interest in objects or events that previously worried him, commits ridiculous acts, etc. In addition, a person may have new hobbies that were previously completely atypical for him. As a rule, philosophical or orthodox religious teachings, fanaticism in following an idea (for example, vegetarianism, etc.) become such new hobbies in schizophrenia. As a result of the restructuring of a person's personality, the working capacity and the degree of his socialization are significantly reduced.

In addition to these signs, there are also symptoms of schizophrenia, which include single manifestations of the disease. The whole set of symptoms of schizophrenia is divided into the following large groups:

• Positive (productive) symptoms;
• Negative (deficiency) symptoms;
• Disorganized (cognitive) symptoms;
• Affective (mood) symptoms.

Positive symptoms of schizophrenia

Positive symptoms include symptoms that a healthy person did not previously have and they appeared only with the development of schizophrenia. That is, in this case, the word "positive" is not used in the sense of "good", but only reflects the fact that something new has appeared. That is, there was a certain increase in the qualities inherent in man.

Positive symptoms of schizophrenia include:

• Rave;
• hallucinations;
• Illusions;
• A state of arousal;
• Inappropriate behaviour.

Illusions represent an incorrect vision of a truly existing object. For example, instead of a chair, a person sees a closet, and perceives a shadow on the wall as a person, etc. Illusions should be distinguished from hallucinations, since the latter have fundamentally different characteristics.

Hallucinations are a violation of the perception of the surrounding reality with the help of the senses. That is, hallucinations are understood as certain sensations that do not exist in reality. Hallucinations are divided into auditory, visual, olfactory, tactile and gustatory depending on which sense organ they affect. In addition, hallucinations can be simple (individual sounds, noise, phrases, flashes, etc.) or complex (coherent speech, certain scenes, etc.).

Auditory hallucinations are most often observed when a person hears voices in his head or in the world around him, sometimes it seems to him that the thoughts were not produced by him, but put into the brain, etc. Voices and thoughts can give commands, advise something, discuss events, speak vulgarities, make you laugh, etc.

Visual hallucinations develop less frequently and, as a rule, in combination with hallucinations of other types - tactile, gustatory, etc. It is the combination of several types of hallucinations that gives a person a substrate for their subsequent delusional interpretation. So, some discomfort in the genital area is interpreted as a sign of rape, pregnancy or illness.

It should be understood that for a patient with schizophrenia, his hallucinations are not a figment of the imagination, but he really feels it all. That is, he sees aliens, atmospheric control threads, smells of roses from the cat litter and other non-existent things.

Rave is a collection of certain beliefs, conclusions or conclusions that are completely untrue. Delusions can be independent or provoked by hallucinations. Depending on the nature of beliefs, delusions of persecution, influence, power, greatness or attitude are distinguished.

The most common delusion of persecution develops, in which it seems to a person that someone is pursuing him, for example, aliens, parents, children, policemen, etc. Every minor event in the surrounding space seems to be a sign of surveillance, for example, tree branches swaying in the wind are perceived as a sign of observers sitting in ambush. The met person in glasses is perceived as a messenger who goes to report on all his movements, etc.

Delusions of influence are also very common and are characterized by the idea that a person is being affected in some way, either negatively or positively, such as DNA rearrangement, exposure to radiation, suppression of the will by psychotropic weapons, medical experiments, etc. In addition, with this form of delusion, a person is sure that someone controls his internal organs, body and thoughts, putting them directly into the head. However, the delirium of influence may not have such vivid forms, but disguise itself as forms that are quite similar to reality. For example, a person each time gives a piece of cut sausage to a cat or dog, because he is sure that they want to poison him.

The delusion of dysmorphophobia is a strong belief in the presence of shortcomings that need to be corrected, for example, to straighten protruding ribs, etc. The delusion of reformism is the constant invention of some new powerful devices or systems of relationships that in reality are not viable.

Inappropriate behavior represents either naive stupidity, or strong agitation, or manners and appearance inappropriate for the situation. Typical variants of inappropriate behavior include depersonalization and derealization. Depersonalization is a blurring of the boundaries between self and non-self, as a result of which one’s own thoughts, internal organs and body parts seem to a person not their own, but brought from outside, random people are perceived by relatives, etc. Derealization is characterized by an increased perception of any minor details, colors, smells, sounds, etc. Because of this perception, it seems to a person that everything is not happening for real, and people, like in a theater, play roles.

The most severe variant of inappropriate behavior is catatonia, in which a person takes awkward postures or randomly moves. Clumsy poses are usually taken by a person in a stupor and hold them for a very long time. Any attempt to change his situation is useless, because he has a resistance that is almost impossible to overcome, because schizophrenics have incredible muscle strength. A special case of awkward postures is wax flexibility, which is characterized by holding any part of the body in one position for a long time. When excited, a person begins to jump, run, dance and make other meaningless movements.
Also referred to as inappropriate behavior hebephrenia- excessive foolishness, laughter, etc. A person laughs, jumps, laughs and performs other similar actions, regardless of the situation and location.

Negative symptoms of schizophrenia

The negative symptoms of schizophrenia are the disappearance or significantly reduced previously existing functions. That is, before the disease, a person had some qualities, and after the development of schizophrenia, they either disappeared or became much less pronounced.

In general, the negative symptoms of schizophrenia are described as loss of energy and motivation, reduced activity, lack of initiative, poverty of thought and speech, physical passivity, emotional poverty, and narrowing of interests. A patient with schizophrenia appears passive, indifferent to what is happening, taciturn, motionless, etc.

However, with a more accurate selection of symptoms, the following are considered negative:

• Passivity;
• Loss of will;
• Complete indifference to the outside world (apathy);
• Autism;
• Minimal expression of emotions;
• Flattened affect;
• Inhibited, sluggish and mean movements;
• Speech disorders;
• Disorders of thought;
• Inability to make decisions;
• Inability to maintain a normal coherent dialogue;
• Low ability to concentrate;
• Rapid exhaustion;
• Lack of motivation and lack of initiative;
• mood swings;
• Difficulty in constructing an algorithm for sequential actions;
• Difficulty in finding a solution to the problem;
• Poor self-control;
• Difficulty switching from one activity to another;
• Ahedonism (inability to experience pleasure).

Due to the lack of motivation, schizophrenics often stop leaving the house, do not perform hygiene procedures (do not brush their teeth, do not wash, do not look after their clothes, etc.), as a result of which they acquire a neglected, sloppy and repulsive appearance.

The speech of a person suffering from schizophrenia is characterized by the following features:

• Constant jumping on various topics;
• The use of new, invented words that are understandable only to the person himself;
• Repetition of words, phrases or sentences;
• Rhyming - speaking in meaningless rhyming words;
• Incomplete or jerky responses to questions;
• Sudden silences due to blockage of thoughts (sperrung);
• The influx of thoughts (mentism), expressed in rapid incoherent speech.

Autism is a detachment of a person from the outside world and immersion in his own little world. In this state, the schizophrenic seeks to withdraw from contact with other people and live in solitude.

Various disorders of will, motivation, initiative, memory and attention are collectively referred to as depletion of energy potential , since a person quickly gets tired, cannot perceive a new one, analyzes the totality of events poorly, etc. All this leads to a sharp decrease in the productivity of his activity, as a result of which, as a rule, his ability to work is lost. In some cases, a super-valuable idea is formed in a person, which consists in the need to preserve strength, and manifests itself in a very careful attitude towards one's own person.

Emotions in schizophrenia become weakly expressed, and their spectrum is very poor, which is usually called flattened affect . First, a person loses responsiveness, compassion and the ability to empathize, as a result of which the schizophrenic becomes selfish, indifferent and cruel. In response to various life situations a person can react in a completely atypical and incongruous way, for example, be completely indifferent to the death of a child or take offense at an insignificant action, word, look, etc. Very often, a person can experience deep affection and obey any one close person.

With the progression of schizophrenia, a flattened affect can take on peculiar forms. For example, a person can become eccentric, explosive, unrestrained, conflict, angry and aggressive, or, on the contrary, acquire complaisance, euphoric high spirits, stupidity, uncriticality to actions, etc. With any variant of a flattened affect, a person becomes sloppy and prone to gluttony and masturbation.

Violations of thinking are manifested by illogical reasoning, incorrect interpretation of everyday things. Descriptions and reasoning are characterized by the so-called symbolism, in which real concepts are replaced by completely different ones. However, in the understanding of patients with schizophrenia, it is these concepts that do not correspond to reality that are symbols of some real things. For example, a person walks naked, but explains it this way - nudity is needed to remove a person’s stupid thoughts. That is, in his thinking and consciousness, nudity is a symbol of liberation from stupid thoughts.

A special variant of thought disorder is reasoning, which consists in constant empty reasoning on abstract topics. Moreover, the ultimate goal of reasoning is completely absent, which makes them meaningless. In severe schizophrenia, it can develop schizophasia, representing the pronunciation of unrelated words. Often these words are combined by patients into sentences, observing the correctness of cases, but they do not have any lexical (semantic) connection.

With the predominance of negative symptoms of depression of the will, the schizophrenic easily falls under the influence of various sects, criminal groups, asocial elements, obeying their leaders implicitly. However, a person may retain a will that allows him to perform some senseless action to the detriment of normal work and social intercourse. For example, a schizophrenic can draw up a detailed plan of a cemetery with the designation of each grave, count the number of any letters in one or another literary work etc.

Anhedonia represents the loss of the ability to enjoy anything. So, a person cannot eat with pleasure, take a walk in the park, etc. That is, against the background of anhedonia, a schizophrenic, in principle, cannot enjoy even those actions, objects or events that previously gave him it.

Disorganized symptoms

Disorganized symptoms are a special case of productive ones, since they include chaotic speech, thinking and behavior.

affective symptoms

Affective symptoms are various options for lowering mood, for example, depression, suicidal thoughts, self-blame, self-flagellation, etc.

Typical syndromes characteristic of schizophrenia

These syndromes are formed only from positive or negative symptoms and represent the most common combinations of manifestations of schizophrenia. In other words, each syndrome is a collection of the most frequently combined individual symptoms.

So, The typical positive syndromes of schizophrenia include the following:

• hallucinatory-paranoid syndrome - is characterized by a combination of unsystematic delusions (most often persecution), verbal hallucinations and mental automatism (repetitive actions, a feeling that someone controls thoughts and body parts, that everything is not real, etc.). All symptoms are perceived by the patient as something real. There is no sense of artificiality.
• Kandinsky-Clerambault Syndrome - refers to a variety of hallucinatory-paranoid syndrome and is characterized by the feeling that all visions and disorders of a person are violent, that someone created them for him (for example, aliens, Gods, etc.). That is, it seems to a person that thoughts are put into his head, internal organs, actions, words and other things are controlled. Periodically there are episodes of mentism (an influx of thoughts), alternating with periods of withdrawal of thoughts. As a rule, there is a completely systematized delusion of persecution and influence, in which a person explains with complete conviction why he was chosen, what they want to do to him, etc. A schizophrenic with the Kandinsky-Clerambault syndrome believes that he does not control himself, but is a puppet in the hands of persecutors and evil forces.
• paraphrenic syndrome - characterized by a combination of delusions of persecution, hallucinations, affective disorders and the Kandinsky-Clerambault syndrome. Along with the ideas of persecution, a person has a clear conviction in his own power and power over the world, as a result of which he considers himself the ruler of all the Gods, the solar system, etc. Under the influence of his own delusional ideas, a person can tell others that he will create a paradise, change the climate, transfer humanity to another planet, etc. The schizophrenic himself feels himself in the center of grandiose, supposedly ongoing events. An affective disorder consists in a constantly high mood up to a manic state.
• Capgras syndrome- is characterized by the delusional idea that people can change their appearance to achieve any goals.
• Affective paranoid syndrome - characterized by depression, delusional ideas of persecution, self-accusations and hallucinations with a vivid accusatory character. In addition, this syndrome can be characterized by a combination of megalomania, noble birth and hallucinations of a laudatory, glorifying and approving character.
• catatonic syndrome - characterized by freezing in a certain position (catalepsy), giving parts of the body some uncomfortable position and maintaining it for a long time (waxy mobility), as well as strong resistance to any attempts to change the adopted position. Mutism can also be noted - dumbness with intact speech apparatus. Any external factors, such as cold, humidity, hunger, thirst and others, cannot force a person to change the absent facial expression with almost completely absent facial expressions. In contrast to being frozen in a certain position, arousal may appear, characterized by impulsive, senseless, frivolous and campy movements.
• hebephrenic syndrome - characterized by foolish behavior, laughter, mannerisms, making faces, lisping, impulsive actions and paradoxical emotional reactions. Perhaps a combination with hallucinatory-paranoid and catatonic syndromes.
• Depersonalization-derealization syndrome - is characterized by feelings of painful and extremely unpleasant experience about changes in one's own personality and the behavior of the surrounding world, which the patient cannot explain.

Typical negative syndromes of schizophrenia are as follows:

• Thinking Disorder Syndrome - manifested by diversity, fragmentation, symbolism, blockage of thinking and reasoning. The diversity of thinking is manifested by the fact that insignificant features of things and events are perceived by a person as the most important. At the same time, the speech is detailed with a description of the details, but vague and unclear in relation to the general main idea of ​​the patient's monologue. The fragmentation of speech is manifested by the fact that a person builds sentences from words and phrases that are unrelated in meaning, which, however, are grammatically connected by correct cases, prepositions, etc. A person cannot complete a thought, because he constantly deviates from a given topic by associations, jumps to other topics, or begins to compare something incomparable. In severe cases, the fragmentation of thinking is manifested by a stream of unrelated words (verbal okroshka). Symbolism is the use of a term as a symbolic designation of a completely different concept, thing or event. For example, with the word stool, the patient symbolically denotes his legs, etc. Blockage of thinking is a sharp break in the thread of thought or loss of the topic of conversation. In speech, this is manifested by the fact that a person begins to say something, but abruptly stops, without even finishing a sentence or phrase. Reasoning is fruitless, lengthy, empty, but numerous reasoning. In speech, a patient with schizophrenia can use his own invented words.
• Syndrome emotional disturbances - characterized by the extinction of reactions and coldness, as well as the appearance of ambivalence. People lose emotional ties with loved ones, losing compassion, pity and other similar manifestations, becoming cold, cruel and insensitive. Gradually, as the disease develops, emotions disappear completely. However, not always in a patient with schizophrenia, who does not show emotions in any way, those are completely absent. In some cases, a person has a rich emotional spectrum and is extremely burdened by the fact that he is not able to express it fully. Ambivalence is the simultaneous presence of opposite thoughts and emotions in relation to the same object. The consequence of ambivalence is the inability to make a final decision and make a choice from the possible options.
• Will disorder syndrome (aboulia or hypobulia) - characterized by apathy, lethargy and lack of energy. Such disorders of the will cause a person to be fenced off from the outside world and become isolated in himself. With strong violations of the will, a person becomes passive, indifferent, without initiative, etc. Most often, will disorders are combined with those in the emotional sphere, so they are often combined into one group and are called emotional-volitional disorders. In each individual person, volitional or emotional disturbances may predominate in the clinical picture of schizophrenia.
• Personality Change Syndrome is the result of the progression and deepening of all negative symptoms. A person becomes mannered, absurd, cold, withdrawn, uncommunicative and paradoxical.

Symptoms of schizophrenia in men, women, children and adolescents

Schizophrenia at any age in both sexes manifests itself with exactly the same symptoms and syndromes, in fact, without any significant features. The only thing to consider when determining the symptoms of schizophrenia is the age norms and characteristics of people's thinking.

The first symptoms of schizophrenia (initial, early)

Schizophrenia usually develops gradually, that is, some symptoms first appear, and then they intensify and are supplemented by others. The initial manifestations of schizophrenia are called symptoms of the first group, which include the following:

• Speech disorders. As a rule, a person begins to answer any questions in monosyllables, even those where a detailed answer is required. In other cases, it cannot exhaustively answer the question posed. It is rare that a person is able to answer a question in full, but he speaks slowly at the same time.
• Anhedonia- the inability to enjoy any activities that previously fascinated a person. For example, before the onset of schizophrenia, a person loved to embroider, but after the onset of the disease, this activity does not fascinate him at all and does not give pleasure.
• weak expression or complete absence emotions. The person does not look into the eyes of the interlocutor, the face is expressionless, it does not reflect any emotions and feelings.
• Failure to complete any task because the person does not see the point in it. For example, a schizophrenic does not brush his teeth because he does not see the point in it, because they will get dirty again, etc.
• Weak focus on any subject.

Symptoms of different types of schizophrenia

Currently, based on the syndromes prevailing in the clinical picture, according to international classifications allocate the following types schizophrenia:
1. paranoid schizophrenia;
2. catatonic schizophrenia;
3. Hebephrenic (disorganized) schizophrenia;
4. undifferentiated schizophrenia;
5. Residual schizophrenia;
6. Post-schizophrenic depression;
7. Simple (mild) schizophrenia.

Paranoid (paranoid) schizophrenia

A person has delusions and hallucinations, but normal thinking and adequate behavior will remain. The emotional sphere at the beginning of the disease also does not suffer. Delusions and hallucinations form paranoid, paraphrenic syndromes, as well as the Kandinsky-Clerambault syndrome. At the beginning of the disease, delusions are systemic, but as schizophrenia progresses, it becomes fragmentary and incoherent. Also, as the disease progresses, a syndrome of emotional-volitional disorders appears.

Catatonic schizophrenia

The clinical picture is dominated by movement and behavioral disturbances, which are combined with hallucinations and delusions. If schizophrenia proceeds paroxysmal, then catatonic disorders are combined with oneiroid(a special state in which a person, on the basis of vivid hallucinations, experiences battles of the titans, intergalactic flights, etc.).

Hebephrenic schizophrenia

The clinical picture is dominated by impaired thinking and a syndrome of emotional disorders. A person becomes fussy, foolish, mannered, talkative, prone to reasoning, his mood is constantly changing. Hallucinations and delusions are rare and ridiculous.

Simple (mild) schizophrenia

Negative symptoms predominate, and attacks of hallucinations and delusions are relatively rare. Schizophrenia begins with the loss of vital interests, as a result of which a person does not strive for anything, but simply wanders aimlessly and idly. As the disease progresses, activity decreases, apathy develops, emotions are lost, speech becomes poor. Productivity at work or school drops to zero. There are very few or no hallucinations or delusions.

Undifferentiated schizophrenia

Undifferentiated schizophrenia is characterized by a combined manifestation of symptoms of paranoid, hebephrenic and catatonic types of the disease.

Residual schizophrenia

Residual schizophrenia is characterized by the presence of slightly pronounced positive syndromes.

Post-schizophrenic depression

Post-schizophrenic depression is an episode of a disease that occurs after a person has been cured of the disease.

In addition to the above, some doctors additionally distinguish manic schizophrenia.

Manic schizophrenia (manic-depressive psychosis)

The main ones in the clinical picture are obsessions and delusions of persecution. Speech becomes verbose and plentiful, as a result of which a person can talk for hours literally about everything that surrounds him. Thinking becomes associative, resulting in unrealistic relationships between the objects of speech and analysis. In general, at present, the manic form of schizophrenia does not exist, since it has been isolated into a separate disease - manic-depressive psychosis.

Depending on the nature of the course, continuous and paroxysmal-progressive forms of schizophrenia are distinguished. In addition, in modern Russia and former USSR isolated recurrent and sluggish types of schizophrenia, which in modern classifications correspond to the terms schizoaffective disorder and schizotypal disorder. Consider the symptoms of acute (stage of psychosis paroxysmal-progredient form), continuous and sluggish schizophrenia.

Acute schizophrenia (attacks of schizophrenia) - symptoms

The term acute is usually understood as the period of an attack (psychosis) of paroxysmal progressive schizophrenia. In general, as the name implies, this type of schizophrenia is characterized by alternating acute attacks and periods of remission. Moreover, each subsequent attack is more severe than the previous one, and after it there are irreversible consequences in the form of negative symptoms. The severity of symptoms also increases from one attack to another, and the duration of remissions is reduced. In incomplete remission, a person does not leave anxiety, suspicion, a delusional interpretation of any actions of people around him, including relatives and friends, and is also disturbed by periodic hallucinations.

An attack of acute schizophrenia can occur in the form of psychosis or oneiroid. Psychosis is characterized by vivid hallucinations and delusions, a complete detachment from reality, persecution mania or depressive detachment and self-absorption. Any mood swings cause changes in the nature of hallucinations and delusions.

Oneiroid is characterized by unlimited and very vivid hallucinations and delusions, which concern not only the surrounding world, but also oneself. Thus, a person imagines himself as some other object, for example, pockets, a disc player, a dinosaur, a machine that is at war with people, etc. That is, a person experiences complete depersonalization and derealization. At the same time, within the framework of the delusional-illusory representation of oneself as someone or something that has arisen in the head, whole scenes from the life or activity of that with which the person has identified himself are played out. Experienced images cause motor activity, which can be excessive or, on the contrary, catatonic.

Continuous schizophrenia

Continuous schizophrenia is characterized by a slow and constant progression of the severity of negative symptoms that are recorded constantly without periods of remission. As the disease progresses, the brightness and severity of the positive symptoms of schizophrenia decrease, but the negative ones become more and more severe.

Sluggish (hidden) schizophrenia

This type of schizophrenia has many different names, such as mild, non-psychotic, microprocessing, rudimentary, sanatorium, pre-phase, slow-flowing, latent, larved, amortized, pseudo-neurotic, occult, non-regressive. The disease does not have a progredient, that is, over time, the severity of symptoms and the degradation of the personality do not increase. Clinical picture sluggish schizophrenia is significantly different from all other types of the disease, since it lacks delusions and hallucinations, but there are neurotic disorders, asthenia, depersonalization and derealization.

Sluggish schizophrenia has the following stages:

• Debut- proceeds inconspicuously, as a rule, at puberty;
• Manifest period - characterized clinical manifestations, the intensity of which never reaches the level of psychosis with delusions and hallucinations;
• Stabilization- complete elimination of manifest symptoms for a long period of time.

The symptomatology of the manifesto of sluggish schizophrenia can be very variable, since it can proceed according to the type of asthenia, neurosis obsessive states, hysteria, hypochondria, paranoia, etc. However, with any variant of the manifesto of indolent schizophrenia, a person has one or two of the following defects:
1. Verschreuben- a defect, expressed in strange behavior, eccentricity and eccentricity. The person makes uncoordinated, angular, child-like movements with a very serious facial expression. The general appearance of a person is sloppy, and the clothes are completely awkward, pretentious and ridiculous, for example, shorts and a fur coat, etc. The speech is equipped with unusual turns and is replete with descriptions of minor minor details and nuances. Productivity of physical and mental activity saved, that is, a person can work or study, despite the eccentricity.
2. Pseudopsychopatization - a defect expressed in a huge number of overvalued ideas with which a person literally gushes. At the same time, the individual is emotionally charged, he is interested in all those around him, whom he is trying to attract to implement countless overvalued ideas. However, the result of such violent activity is negligible or completely absent, therefore the productivity of the individual's activity is zero.
3. Energy potential reduction defect - expressed in the passivity of a person who is mostly at home, not wanting to do anything.

Neurosis-like schizophrenia

This variety refers to sluggish schizophrenia with neurosopod manifestations. A person is disturbed by obsessive ideas, but he is not emotionally charged to fulfill them, so he has hypochondria. Compulsions exist for a long time.

Alcoholic schizophrenia - symptoms

As such, alcoholic schizophrenia does not exist, but alcohol abuse can trigger the development of the disease. The state in which people find themselves after prolonged use of alcohol is called alcoholic psychosis and has nothing to do with schizophrenia. But due to pronounced inappropriate behavior, impaired thinking and speech, people call this condition alcoholic schizophrenia, since the name of this particular disease and its common sense everyone knows.

Alcoholic psychosis can occur in three ways:

• Delirium (delirium tremens) - occurs after the cessation of consumption of alcoholic beverages and is expressed in the fact that a person sees devils, animals, insects and other objects or living beings. In addition, a person does not understand where he is and what is happening to him.
• Hallucinosis- occurs during drinking. A person is disturbed by auditory hallucinations of a threatening or accusatory nature.
• delusional psychosis- occurs with prolonged, regular and fairly moderate alcohol consumption. It is expressed by delusions of jealousy with persecution, attempts at poisoning, etc.

Symptoms of hebephrenic, paranoid, catatonic and other types of schizophrenia - video

Schizophrenia: causes and predisposing factors, signs, symptoms and manifestations of the disease - video

Causes and symptoms of schizophrenia - video

Signs of schizophrenia (how to recognize the disease, diagnosis of schizophrenia) - video

Post-traumatic syndrome or post-traumatic stress disorder (PTSD) - causes, symptoms, diagnosis, treatment and rehabilitation

Diseases of the nervous system are quite common in people with a hereditary predisposition. Most of them are treatable, after which the person returns to a full life. But, this is what schizophrenia is and whether it is possible to get rid of it completely or not, unfortunately, even a qualified doctor still cannot answer these questions accurately. But the fact that this disease leads to a complete loss of ability to work has been proven repeatedly.

Schizophrenia is one of the most dangerous ailments of the nervous system, which suppresses the will of the patient, which ultimately leads to a deterioration in the quality of his life. However, in some cases, the development of pathology can be suspended, preventing disability. The types of schizophrenia and, accordingly, its forms can be different, and they differ significantly from each other, but psychiatrists say that this disease is not one ailment, but several types of illness.

Despite the observations and research of specialists, the origin of the syndrome has not been fully established. Therefore, schizophrenia and its symptoms are still a hot topic. And in the common people, this disease is known under such a name as “split personality” (due to the patient’s behavior, the illogicality of his thinking). More often early symptoms pathologies make themselves felt at the age of 15-25 years and in the absence of adequate therapy they progress rapidly.

The main role in the appearance of the disease is played by the hereditary factor. External causes (disorders of the psyche, nervous system, past illnesses, head injuries, etc.) are only of secondary importance and are only an activator of the pathological process.

How does the insidious syndrome manifest itself?

Experts are cautious about the study of schizophrenia and the final definition of this diagnosis. Explore a wide range possible violations: neurosis-like and mental.

Among the emotional symptoms of the disease, the main signs are:

• Prostration - a person has complete indifference in the fate of people close to him.
• Inappropriate behavior is also present - in some cases, there is a strong reaction to various stimuli: every trifle can cause aggression, attacks of inadequate jealousy, anger. They suffer, and from this native people. With strangers, the patient behaves as usual. The first signs of schizophrenia are the loss of interest in everyday activities, things.
• Dullness of instinct - a person suddenly has a loss of food, he has no desire to lead a normal life, to monitor his appearance. All syndromes of schizophrenia are also accompanied by delusions, manifested in the wrong perception of everything that is happening around.
• The patient sees strange colored dreams, he is haunted intrusive thoughts that someone is constantly watching him, wants to deal with him in sophisticated ways. The patient is trying to convict his other half of treason (while his behavior in schizophrenia is obsessive).
• Hallucinations - often such a disorder makes itself felt in the form of hearing impairment: the patient hears extraneous voices that prompt him with various ideas. The patient may also be disturbed by visual color hallucinations resembling a dream.
• Disturbance of normal thinking. A disease such as schizophrenia, the main symptoms and signs of which are often quite difficult to identify, is accompanied by deviations in the thought process. One of the most serious violations is disorganization in the perception of various information, in which the person’s logic is completely absent. Speech is lost in connection, sometimes it is impossible to make out what the patient is saying.

Another symptom is delay. thought process(the person cannot finish his story). If you ask the patient why he suddenly stopped, he will not be able to answer this question.

• Violations motor functions. The causes of schizophrenia may be different, but regardless of its origin, the patient often has involuntary, awkward and scattered movements, strange mannerisms, various grimaces. The patient can systematically repeat certain actions or fall into prostration - a state of immunity, complete immobility.

If there is no treatment for schizophrenia, then the catatonic syndrome is the first symptom observed in a person. Thanks to modern therapeutic techniques, this phenomenon is quite rare.

If the first signs of schizophrenia are almost impossible to detect at the initial stage of the pathology, then it is impossible to lose sight of hallucinations and delusions.

In families where bouts of unjustified jealousy and scandals, aggression, depression are constantly present, many refer to mental disorders, and only in the last place, relatives begin to think that this is schizophrenia, the main symptoms and signs of which are not yet so pronounced. But with a good relationship, the disease is easy to identify at first. initial stages its development.

The main forms of the syndrome

Specialists identify the main types of schizophrenia and, accordingly, its forms.

Name	Characteristic symptoms
paranoid pathology	How to recognize a schizophrenic in this case? The disease is accompanied by unrealistic ideas, combined with hallucinations from the organs of hearing. Pathologies from the emotional and volitional areas are milder than with other types of illness.
Hebephrenic type of syndrome	The disease begins at a young age. Therefore, it is important to be aware of what schizophrenia is and how to recognize it in order to prevent further development pathological process. With this type of illness, numerous mental disorders are noted: hallucinations, as well as delirium, the patient's behavior can be unpredictable. Diagnosis of schizophrenia in this case is carried out quite quickly.
Catatonic type of pathology	Psychomotor disorders are quite pronounced, with constant fluctuations from an excited state to complete apathy. Whether schizophrenia is curable in this case or not, doctors find it difficult to answer. With this type of disease, negative behavior and submission to certain circumstances are often encountered. Catatonia may be accompanied by vivid visual hallucinations, obscurations of adequate consciousness. How to remove the diagnosis of schizophrenia in the presence of such symptoms, experts are still thinking.
residual syndrome	The chronic stage of the pathological process, in which negative symptoms are often present: a decrease in activity, psychomotor retardation, passivity, lack of emotions, poverty of speech, a person loses initiative. How such schizophrenia is treated and whether it is possible to eliminate negative factors for a certain period of time, only a specialist can answer after a thorough examination of the patient.
simple disease	Another type of pathology, with a latent, but rapid development of the process: strange behavior, lack of ability to lead a socially adequate standard of living, lowering physical activity. There are no episodes of acute psychosis. A disease such as schizophrenia is dangerous, how to treat it can be found out only after an examination.

Schizophrenic psychosis and "split personality" are two types of pathology, the course of which is sometimes similar. Clinical signs, most likely act as additional symptoms of the syndrome, which may not appear. Psychosis is dominated by hallucinations and delusions. Schizophrenia is treatable (you can stop its progression), but for this it is necessary to recognize it in a timely manner.

Alcohol syndrome: signs

This pathology, as such, does not exist, but the systematic use of alcohol can trigger the mechanism for the development of the disease. The state in which a person is after a long "binge" is called psychosis and is a mental illness and does not apply to schizophrenia. But because of inadequate behavior, people call this disease alcoholic schizophrenia.

Psychosis after prolonged alcohol consumption can occur in several ways:

1. Delirium tremens - appears after giving up alcohol and is characterized by the fact that a person begins to see various animals, devils, living beings, strange objects. In addition, he does not understand what is happening to him and where he is. In this case, schizophrenia is curable - you just need to stop abusing alcohol.
2. Hallucinosis - appear during prolonged alcohol consumption. The patient is disturbed by visions of an accusatory or threatening nature. Is schizophrenia treatable or not? Yes, in this case, you can get rid of it, after proper therapy.
3. Delusional syndrome - observed with systematic, prolonged consumption of alcohol. Characterized by poisoning attempts, harassment and jealousy.

A disease such as schizophrenia is dangerous and the causes of its occurrence in this case play a special role, since after giving up alcohol and appropriate treatment, you can get rid of the pathology forever.

How to establish the presence of a "split personality"?

Schizophrenia and its diagnosis play a special role in a patient's life. Therefore, it is necessary to establish the presence of an ailment in a timely manner. According to the established rules, the examination is carried out according to certain criteria and in sufficient detail. First going primary information, including a medical survey, complaints, the nature of the development of the disease.

What kind of disease it is and the main reasons for the rapid development of schizophrenia can be found using the main diagnostic methods:

1. Special testing of psychological orientation. This technique is informative at the initial stages of the disease.
2. MRI of the brain - through this procedure, the presence of certain disorders in the patient (encephalitis, hemorrhages, malignant neoplasms) that can affect human behavior. Since the symptoms of the disease, regardless of the type of disease, are somewhat similar to the signs of organic brain disorders.
3. Electroencephalography - establishes injuries, pathologies of the brain.
4. Research in the laboratory: biochemistry, urinalysis, hormonal status, as well as an immunogram.

Used to determine an accurate diagnosis additional methods examinations: examination of arteries, study of sleep, virological diagnostics. It is only possible to finally identify the manifestation of a “split personality” and prescribe an adequate treatment for schizophrenia if a person has signs of the syndrome for six months. Must establish at least one overt, as well as several vague symptoms:

• violation of the normal thought process, in which the patient believes that his thoughts do not belong to him;
• feeling of influence from the outside: the belief that all actions are carried out under the direction of an outsider;
• inadequate perception of behavior or speech;
• hallucinations: olfactory, auditory, visual, and also tactile;
• obsessive thoughts (for example, excessive jealousy);
• confusion of consciousness, failures of motor functions: restlessness or stupor.

With a comprehensive examination of the pathology, every tenth patient is misdiagnosed, since the causes of schizophrenia, as well as its manifestation, can be different, so it is not always possible to identify a dangerous illness in a timely manner.

How to provide adequate therapy

Most psychiatrists suggest that the treatment of schizophrenia, that is, the stage of its exacerbation, is best done in a hospital, especially at the first mental disorder. Of course, the hospital should be well equipped and use only modern ways diagnostics and therapy. Only in this case it is possible to obtain a more accurate picture of the disease, as well as to select the appropriate methods of treatment for schizophrenia.

But do not forget that being in a hospital is stressful for a patient, because it completely limits his freedom of action. Therefore, hospitalization must be fully justified, the decision must be made taking into account all factors and after exploring other alternatives.

Duration of adequate therapy

Regardless of the type of schizophrenia, the treatment of the disease should be constant and long enough. Often, after the first attack, therapy with psychotropic drugs and antipsychotics is prescribed for several years, and after a second episode - at least five.

About 70% of patients stop taking the medicine, as they feel completely healthy, not realizing that they have just entered the remission stage. Another category of patients suffering from schizophrenia refuses maintenance medications due to lack of effectiveness of therapy, as well as weight gain and drowsiness.

How to prevent possible relapses?

The main task of therapy is the treatment of the disease, aimed at preventing seizures. For these purposes, doctors use prolonged-acting medications: Rispolept-Konsta, Fluanxol-Depot, and only in some cases because of the negative effect on the symptoms of the Clopixol-Depot syndrome.

Supportive therapy should be long-term and carried out under the constant supervision of physicians, taking into account the rate of development of biochemical, hormonal, and neurophysiological parameters, and include psychotherapy sessions with the patient. It is necessary to teach the patient's relatives the tactics of their behavior, which will prevent the recurrence of the disease.

Are people with split personality disorder aggressive?

Patients with a diagnosis such as schizophrenia are practically not prone to psychosis, violence, most often they prefer peace. According to statistics, if the patient has never crossed the boundaries of the law, then even after he has a disease, he will not commit a crime. If someone with a diagnosis of "split personality" behaves aggressively, then often his actions are directed at people close to him and manifest themselves within the home.

The treatment of the “split personality” syndrome is a rather difficult task, both for the public and for physicians. Therefore, the question of whether schizophrenia can be cured remains relevant to this day. Timely therapy and medicines preserve the quality of the patient's habitual lifestyle, ability to work and social level, thereby allowing him to provide for himself and help his loved ones.

Schizophrenia is such a multifaceted disease in its manifestations that it is sometimes quite difficult to recognize it in time. Before the appearance of the first obvious signs the disease can develop slowly for years, and some oddities that appear in a person's behavior are mistaken by many for a spoiled character or teenage changes. At the same time, noticing such oddities, people often, instead of going to a psychologist or psychiatrist, run to grandmothers or traditional healers to remove damage, roll out eggs, buy “magic” herbs, etc. Such actions only lead to a worsening of the patient's condition and a delay in professional therapy. But it is precisely the early diagnosis of schizophrenia and timely treatment that can significantly improve the prognosis of the disease and get high chances for full recovery. What signs make it possible to suspect the approach of the disease and reveal a tendency to schizophrenia?

Signs of schizophrenic disorder at the premorbid stage

Schizophrenia is an endogenous disease and is associated with biochemical disorders of the brain. And pathological processes in the brain cannot but affect the behavior and thinking of a person. In childhood or adolescence, a person who may later develop schizophrenia does not stand out from the rest of the people. However, some signs are still worth paying attention to. Such children are usually a little withdrawn, may experience difficulties in learning. Behind them, you can notice some odd behaviors, for example, washing hands too often, unusual hobbies, coldness towards animals. Of course, the fact that a child is behind in school and behaves introverted does not mean that he will necessarily suffer schizophrenia in the future. It's just that such a child or teenager should be observed more carefully. Consultation with a child psychologist will also not be superfluous.

The incubation period of the disease

As the pathological processes of the brain in schizophrenia worsen, changes in the psyche and thinking become more pronounced. The incubation (prodromal) stage of the disease lasts an average of about three years. Relatives do not always pay attention to gradually increasing oddities in the patient's behavior, especially if this coincides with adolescence. Signs of the disease at this stage, allowing you to understand whether a person has schizophrenia, may be as follows:

• strange behavioral reactions;
• desire for solitude, decreased initiative and energy levels;
• change in handwriting (for example, handwriting may become illegible or the slope of letters in handwriting changes);
• change in personality traits (a diligent and punctual teenager suddenly becomes absent-minded and careless);
• deterioration of creative, educational or labor abilities;
• episodic simple hallucinatory or illusory manifestations;
• new overvalued hobbies, for example, philosophy, mysticism, religious ideas.

Graphologists believe that it is possible to understand whether there is a predisposition to schizophrenia by the handwriting of a person.

Handwriting can say a lot about personality and thinking patterns. However, illegible and intermittent handwriting does not in itself indicate schizophrenia, there must be others. characteristic manifestations illness. If you begin to notice a change in handwriting and other signs in yourself or in loved one, it is necessary to consult with a psychiatrist as soon as possible.

Self-diagnosis

Diagnosing schizophrenia is a difficult task even for experienced professionals. What can we say about trying to find out about the presence of such a complex disease on your own. An accurate diagnosis with determining the form of the disorder can only be made after a series of examinations, differential diagnosis and a conversation with a doctor. However, often people, in view of their negative attitude towards psychiatry and stereotypical beliefs, are afraid to turn to a psychiatrist, even if they find themselves warning signs. Therefore, many are interested in how to determine schizophrenia in oneself without the help of a psychiatrist? You can figure out if you have a reason to be concerned about schizophrenia with some self-diagnosis techniques.

To get started, try the following statements on yourself:

• it is difficult for me to remember recent events, but what happened a long time ago is clearly remembered;
• boredom attacks me from most conversations and new acquaintances are not interesting to me;
• sometimes it is difficult for me to carry out daily duties;
• sometimes I have thoughts that I am acting against my will;
• it can be difficult for me to forget even minor grievances;
• I often cannot bring myself to leave the house for days on end;
• I am sometimes attacked by a stupor or sudden excitement with aggression;
• my thoughts are sometimes hazy and confused;
• I am sure that I have unique abilities;
• others try to control my feelings and thoughts;
• I am not interested in anything, and I do not want to do anything;
• I feel that my family is under threat;
• for me, the main adviser is my inner voice, I always consult with him;
• close people annoy me for unknown reasons;
• I notice in myself sometimes a discrepancy between the displayed emotions of the environment and the emotions of other people;
• I often find myself causeless feeling fear;
• it is difficult for me to show a feeling of tenderness and love, I am often immersed in myself.

Think about how true it will be for you to hear the following statements addressed to you from loved ones:

• you are not at all worried about the suffering of other people or animals, your face does not reflect a feeling of compassion;
• you do not look into the eyes of the interlocutor;
• you sometimes talk out loud to yourself;
• you most of all like to spend time alone with yourself, avoid crowded places and attention from others;
• you hear what is not really there, and what others do not hear;
• you began to speak indistinctly (stammer, lisp);
• you began to write worse, your handwriting is somehow strange and illegible;
• you are considered a little eccentric, and strange expressions are noticed on your face;
• you talk to inanimate objects as if they were alive;
• you sometimes laugh or cry for no reason;
• you devote quite a lot of time to meaningless activities (lying for hours, staring at the ceiling with your eyes).

How to evaluate such testing? The more of the above statements apply to you, the higher your tendency and predisposition to schizophrenia and the more important it is for you to visit a specialist. Note that it is inclination! Because, even if absolutely all statements are identical to you, this does not mean that you have a schizophrenic disorder. Only a psychiatrist can make a diagnosis.

You can also understand if you have signs of schizophrenia using the Chaplin Mask visual test, created by the British neuropsychologist R. Gregory. The experience of observing patients shows that a characteristic handwriting of schizophrenia is a person's immunity to visual illusions.

Don't take your eyes off the picture while taking this test. If everything is in order with your psyche, you will notice an optical illusion.

Diagnostics and ITU

The process of diagnosis and ITU (medical and social examination) in schizophrenia can take quite a long time, since the manifestations of the disease are very diverse. Differential diagnosis makes it possible to exclude mental, somatic and neurological pathologies that have symptoms similar to schizophrenia. However, it is not always possible to make an accurate diagnosis immediately, even after differential diagnosis. How is the diagnostic process going? To begin with, the psychiatrist assesses the patient's condition during the conversation. It reveals productive and negative symptoms, as well as the degree of cognitive impairment. Often different tests are used. For example, one can reasonably accurately predict schizophrenia by eye movement.

A person with this pathology cannot smoothly follow a slowly moving object with his eyes. A specific eye movement in schizophrenics is also observed when looking at pictures freely. An experienced doctor is able to recognize signs of pathology in eye movement. It is also difficult for such people to keep their eyes still for a long time and fix their eyes on something. After the conversation, a series of examinations are carried out that allow us to assess the features of the central nervous system, to identify comorbidities and endocrine disruptions. Studies such as EEG, MRI, TDS (special ultrasound scanning of cerebral vessels) allow more accurate differential diagnosis assess the severity of schizophrenia and select the most effective drugs. MRI in schizophrenia is one of the effective ways to solve the problem - how to recognize schizophrenia even before its obvious signs appear and the person's well-being worsens. It has been proven that changes in brain structures begin long before the onset of schizophrenia symptoms.

In the process of treatment, at each stage of remission, the patient's MSE is performed. If the exacerbation is of a protracted nature, the MSE can be carried out during the attack. At ITU, the duration and clinical form schizophrenia, dynamics and nature of negative disorders, type and characteristics mental disorders. Also in the process of ITU, it is important to assess how critical the patient is to his condition. At ITU, the stage of the disease, the nature of the leading syndrome and the quality of remissions are assessed. All this is necessary in order to determine the patient's disability group based on the results of the ITU. The first group of disability most often leads to continuous malignant form a disease that develops early and causes a rapid increase in negative disorders.

Statistics indicate that more and more modern people are beginning to suffer from schizophrenia. This is due to the reasons that lead to various forms of the disease. The symptoms appear brightly, so relatives, who will have to take care of a sick person, will need to seek medical treatment.

It is not a mild disease that can be cured in a couple of days. In clinical practice, people remain schizophrenics forever. There is no treatment that can cure a seriously ill schizophrenic, but there is a therapy that alleviates his condition.

Online magazine site talks about chronic disease which makes a person disabled, unable to live in society and adequately perceive the world. Schizophrenia usually manifests itself in adolescence.

What is schizophrenia?

Schizophrenia is a psychotic illness that mainly affects mental loss and emotional distortion. This disorder is characterized by inadequate and reduced affect (emotional reaction), disorder of thinking and perception. Often all this is accompanied by hallucinations (fantastic and auditory), paranoid delusions, disorganization of speech, activity and thinking.

Is it possible to say that the disease affects men or women more? In fact, both sexes become schizophrenics, only in the case of women, the disease manifests itself a little later.

The schizophrenic in the truest sense of the word is no longer part of a healthy society. He cannot do work, even serve himself. but we are talking about a chronic disease that has remissions, that is, periods when the symptoms recede and the person seems to be completely healthy. During such periods, he can begin to do something and even think sensibly. However, one should not hope for a miracle. Schizophrenia is progressive in nature, which entails an increase in the period of exacerbation of symptoms.

Schizophrenia is understood as a whole complex of symptoms, since the disease itself manifests itself in various forms. This sometimes causes debate about the allocation of individual diseases from a single schizophrenia. In the common people, schizophrenia is called a split personality, although in reality a person can have many personalities.

A schizophrenic cannot adequately respond to the world around him, therefore he often shows not quite adequate behavior. A split personality occurs, apathy and emotional fatigue develop, connections with other people are lost. It is easy enough to recognize a schizophrenic in another person, since his behavior is not characteristic of an ordinary person.

However, mention should be made of the various stages and forms of schizophrenia, which mislead people who then find out that they were friends or built love relationships with schizophrenics. In fact, not all people are diagnosed, and some continue to be part of the social environment, but their behavior is not immediately suspicious.

Forms of schizophrenia

Schizophrenia has many faces, just like the person who suffers from it. It distinguishes several forms, the classification of which we consider below:

1. Schneider classification:

• the influence of external forces.
• The sound of one's own thoughts or the feeling that other people are hearing the person's thoughts.
• Voices that comment on the actions or thoughts of the patient or talk among themselves.

1. Downstream classification:

• A simple - imperceptible, but progressive form of the disease, in which oddities in behavior that do not meet the rules of society begin to appear, and a decrease in activity. There are no acute episodes of psychosis.
• Disorganized catatonic - the disease manifests itself at the level of psychomotor, when the patient is either in a stupor, or begins to actively move (excited). The patient is susceptible to negativism and automatic submission. Behavior becomes bizarre. There are vivid visual hallucinations and clouding of consciousness in a dream.
• paranoid - crazy ideas associated with auditory hallucinations. At the same time, strong-willed and emotional sphere practically not broken.
• Residual (residual) — chronic form schizophrenia with such symptoms: decreased activity, psychomotor retardation, passivity, lack of initiative, dulling of emotions, poverty of speech, violation of will.
• Hebephrenic - develops in adolescence, when emotional affects become superficial and inadequate. The patient's behavior becomes unpredictable, mannered and pretentious, delusions and hallucinations are fragmentary, will and emotions are flattened, the symptoms of the disease become vivid.

1. According to ICD:

• Post-schizophrenic depression.
• Simple schizophrenia.

1. By the nature of the flow:

• Continuously - the symptomatology grows, passes without remission. She happens:

1. Hebephrenic, or malignant, is gaining momentum in adolescence, but in childhood it manifests itself in a decrease in academic performance and development.
2. Low-progressive, or sluggish, - develops over many years, manifests itself in adolescence, gradually disintegrates the personality. Accompanied by psychopathic and neurosis-like disorders.

• Paroxysmal - periods of remission are present. It is this form that is often confused with manic-depressive disorder. It happens:

1. Paroxysmal-progredient - the first attack is short, followed by a long remission. Each subsequent attack is long and bright, which worsens the patient's well-being.
2. Recurrent, or periodic, - manifests itself in the form of schizoaffective psychosis with prolonged attacks. It appears at any age. The complete perception of everything that surrounds is disturbed.

From schizophrenia, the following diseases should be distinguished:

1. schizophreniform psychosis - mental illness with easy flow. Individual symptoms of schizophrenia appear, which are additional, and not basic. Hallucinations and delusions predominate here.
2. Schizotypal disorder is a disorder of emotions and thinking, eccentric behavior that is similar to schizophrenia. It is difficult to detect the onset of the disease.
3. Schizoaffective disorder - a combination affective disorder with schizophrenic symptoms. There are manic, depressive and mixed types.

Why does schizophrenia develop?

To date, psychologists cannot name the exact causes of the development of such a terrible disease as schizophrenia. However, they give a list of reasons that may contribute to its development, but not in all cases:

• Heredity. If there is a schizophrenic in the parents' family, then the child may also develop the disease in 10% of cases. In identical twins, if the disease is detected in at least one of the children, the risk of developing schizophrenia in the second child increases to 65%.
• Upbringing. This reason is considered a hypothesis that with little attention from parents to the child, he develops schizophrenia.
• The impact of infection on the development of the baby in the prenatal period.
• Bad habits. Alcohol and drugs, of course, cannot cause schizophrenia, but they increase the symptoms when consumed. Amphetamines, hallucinogenic and stimulant drugs negatively affect a person.
• social factors. These include unemployment, poverty, frequent moving, conflicts in society (wars), hunger. According to some scientists, these factors can either develop a mild form of schizophrenia or exacerbate the symptoms of an existing disease.
• Disruption of connections in the brain. This theory is based on disruption of the work of neurotransmitters, which can also be observed in the prenatal period.

How to recognize schizophrenia?

It seems to many that it is difficult to recognize schizophrenia. However, this is observed only in the initial stages of the disease. If schizophrenia has already gained momentum, then it is easy to recognize.

At the beginning of its development, symptoms may be blurred or absent altogether. This is why schizophrenia seems to be difficult to detect. Some of her symptoms are simply ignored, considered insignificant. However, later, when the disease has reached the peak of its development, all the signs appear:

1. In adults:

• Voices in my head.
• Rave.
• Ideas that do not have a semantic load.
• Feeling that the patient is being watched from the side.
• Lack of emotion.
• Withdrawal from social life.
• Lack of pleasure from anything.
• Arbitrary self-isolation.
• Disorder of memory and thinking.
• Lack of self care.
• Difficulties in processing even primitive information.
• depressive states.
• Mood swings.
• In men: self-isolation, voices in the head, persecution mania, aggressiveness.
• In women: persecution mania, delusions, frequent reflection, conflicts based on social interests, hallucinations.

1. In children (detected from 2 years of age):

• Irritability.
• Rave.
• Motility disorder.

1. For teenagers:

• Aggressiveness.
• Poor progress.
• Closure.

Dementia is a symptom of severe schizophrenia.

How is schizophrenia diagnosed?

Schizophrenia can only be diagnosed by a specialist in the field of psychiatry. He collects the complaints of the patient himself and his close circle, and also observes the behavior. It is remarkable how the schizophrenic thinks and sees the world. At each stage of his illness, the world seems to a person completely different.

The main thing to distinguish schizophrenia from other diseases of the mental class, as well as determine the severity.

How to treat schizophrenia?

Schizophrenia can only be treated by a psychiatrist who prescribes an individual course of antipsychotics, nootropics, mood stabilizers, and vitamins.

Surgical intervention - is used extremely rarely and in situations where other methods do not work.

What are the prognoses for schizophrenia?

There is no hope that schizophrenia can be cured. The origins of its development are unknown, and its appearance is often explained by a predisposition or malfunction of the brain. Forecasts are always more or less favorable, which depends solely on the stage of the disease and how the patient feels as a result of treatment.