Phases of schizophrenia

Do you know the phases of schizophrenia? People with this psychotic spectrum disorder usually go through five. In this article we will talk about the characteristics and symptoms of each of them. In addition, we will learn why it is so important to act in some specific phases.

According to the WHO (World Health Organization), Schizophrenia is a serious mental disorder that affects more than 21 million people worldwide. It is more common in men (12 million) than in women (9 million) and men also develop it at an earlier age.

Phases of schizophrenia

Let’s know the phases of schizophrenia; These are phases contrasted and accepted by experts. Most individuals who suffer from this serious mental disorder go through all of them.

In fact, the American Psychiatric Association (APA, 1999) recognizes four phases of schizophrenia: 1) the prodromal phase, 2) the acute phase, 3) the stabilization phase and 4) the stable or residual phase. Here we will talk about five phases, because we will differentiate the stable phase from the residual phase.

Prodromal phase

The first phase of schizophrenia is the prodromal phase; In it, the patient begins to experience the first symptoms of the disease, which are prior to the acute or active phase.

It is a phase of vital importance because if we work on it, we can reduce the risk of a psychotic break or prevent relapses of the disease. That is, we can prevent this phase from leading to the next one (active phase). This is not easy; To do this, we must be attentive to the characteristic symptoms of the prodromal phase. They are the following:

Concentration difficulties.Nervousness or agitation.Alterations/disorders in schedules and routines (going to bed, getting up…).Symptoms of sadness and depression.Eating disturbances (often lack of appetite). Sleep disturbances (for example insomnia).Social isolation (stop seeing friends, for example). Principles of anhedonia (not enjoying things).Feelings of worthlessness.Worrying about things, rumination.

There are people who only manifest some of these symptoms; Logically, it is not necessary to present all of them to move to an active phase of the disease. Of course, the more symptoms, the more likely they are to trigger the psychotic break or illness (or relapse).

It is important to note that the more relapses the patient suffers, the greater the deterioration experiencedso it will be of great importance to work on the prodromal phase of schizophrenia and be alert to the aforementioned symptoms.

Active/acute phase

The second phase of schizophrenia is the active phase (also called the acute phase). At this stage, it can be said that the patient has gone into crisis or has suffered a psychotic break. This is where the positive symptoms of schizophrenia appear intensely, which, remember, include: hallucinations, delusions, disorganized thinking and language, etc.

This phase is characterized because the individual’s behavior changes a lot; it becomes decompensated and disorganized. In addition, the behavior can become striking and strange. Thus, the typical symptoms of the acute phase are the following:

Positive symptoms of schizophrenia (already mentioned).Distrust of othersreaching paranoia. Flashy, strange and disorganized behavior.

The duration of this phase can vary greatly from one person to another. However, the same person usually has psychotic breaks (active phase) of the same duration each. In this phase the person usually requires hospitalizationdue to the severity of the symptoms.

Stabilization phase

The stabilization phase is also called the recovery phase. In this phase, psychotic symptoms decrease in intensity.. This is the period that begins once the previous phase is resolved, that is, the acute phase. This usually occurs when the patient begins to respond satisfactorily to treatment.

The objective in this phase is twofold: to avoid relapses and to improve the symptoms that are still present. According to Martín & Navarro, in their article Schizophrenia, The average duration of this phase is 6 months.

In the Clinical practice guideline on schizophrenia and early psychotic disorder We find that this phase lasts between 6 and 12 months.

Residual phase

In this phase, also called post-outbreak phase, negative symptoms of schizophrenia appear to a varying degree. One of the possible complications that we find in this phase is the appearance of post-outbreak depression. In this phase, and with depression, suicide prevention will be of vital importance.

What are the negative symptoms of schizophrenia mentioned and that appear in this phase? Let’s list the most important ones:

Alogia: alogia is an impoverishment of thought; It implies slow and little alternative thinking. Furthermore, the language of the person with schizophrenia and this symptom is usually stereotyped, repetitive and poor.Apathy: implies lack of interest and desire for things. In short, it is not having the desire to do anything. There is an absence of concerns and goals (even if they are small).Anhedonia: Anhedonia is the lack of enjoyment of things that previously made us enjoy.

A meta-analysis by Savill et al. (2014) published in the magazine Psychological Medicine suggests that Negative symptoms of schizophrenia show a significant reduction over time, regardless of the type of intervention performed. In the meta-analysis, specifically, it was observed that the symptoms that were reduced were alogia, abulia, apathy, emotional dullness, and social isolation. The symptoms that decreased the most were apathy and apathy.

Stable phase (asymptomatic)

The last of the phases of schizophrenia that we will know is the stable or asymptomatic phase. This is the “sought” phase, since in it the patient appears stable and without symptoms (or with very mild symptoms). When symptoms appear, they are usually: anxiety, depression, tension and/or insomnia, depending on the Therapeutic Guide for the Management of Schizophrenia.

It is a good stage for the psychologist can provide the patient with the necessary tools to prevent relapses and maintain proper functioning and a good degree of well-being. When this phase is broken, that is, the patient decompensates again, then we again enter another of the phases of schizophrenia: the acute phase (psychotic break). That is why working here will also be of great importance, to accompany the patient throughout their process. On a pharmacological level, medication will also be of great importance here (as in all phases).

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