Residual schizophrenia: definition, symptoms and treatment

Residual schizophrenia is a clinical label issued in the residual phase of the disorder. According to existing studies, It appears in 90% of schizophrenia cases. It is included in the DSM-IV-TR and the ICD-10.

Let us remember that The residual phase of schizophrenia is that which appears after the psychotic break or crisis, when the treatment is effective. At this stage, a more or less pronounced deterioration of the premorbid level of functioning is frequently observed and this is when the so-called residual schizophrenia may appear.

In this article we will answer the following questions: what does this disorder consist of? What are your symptoms? How is it treated?

Residual schizophrenia: what is it?

Residual schizophrenia is a diagnostic label used when there has been at least one psychotic episode in the patient’s lifebut currently the psychotic symptoms are attenuated (and the negative symptoms of the disorder, such as anhedonia or emotional dullness, stand out).

Thus, we can diagnose residual schizophrenia when in the patient’s clinical history we find at least one episode of schizophrenia (delusions, hallucinations…), but In the current clinical picture, the typical psychotic symptoms of schizophrenia are attenuated or do not appear at all.. When we talk about typical psychotic symptoms, we refer to hallucinations, delusions, disorganized behavior and language, etc. (i.e., positive symptoms of the disorder).

On the other hand, residual schizophrenia It is characterized by the prominent presence of the negative symptoms of the disorder, such as emotional dullness, poverty of language, apathy and anhedonia, among others. We will talk about them later.

In what manuals do we find it?

Residual schizophrenia It is a clinical category included in the ICD-10 (International Classification of Diseases) as a type of schizophrenia; Specifically, it is located in the section “Schizophrenia, schizotypal disorder and delusional disorder.”

We also find it in the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders), as “Residual type of schizophrenia” within the chapter “Schizophrenia and other psychotic disorders.”

Symptoms

In summary, the symptoms of residual schizophrenia are of two types: negative symptoms (predominant) and positive symptoms (attenuated). Let’s see them in more detail:

Negative symptoms

As we said, in residual schizophrenia the negative symptoms typical of schizophrenia appear with great intensity. These symptoms include:

Lack of initiative.Passivity.Affective dullness.Psychomotor inhibition.Lack of activity. Impoverishment of the quality or content of the language.Impoverished non-verbal communication.Deterioration in personal hygiene and social behavior.

Positive symptoms

Positive symptoms appear in a very attenuated way at the present time of the clinical picture; However, it is necessary that there has been at least one psychotic episode in the past. That is, a requirement is that the diagnosis of schizophrenia has been previously issued.

Other symptoms

In addition to what has been mentioned, in residual schizophrenia it is necessary for another series of conditions to occur. Thus, it is required that:

The attenuated positive symptoms have lasted at least 1 year: that is, it implies that its intensity and frequency have always been attenuated (that entire year).There are no other paintings: such as dementia, organic brain disorder, chronic depression, etc., which may explain the deterioration and symptoms of residual schizophrenia.

Treatment

Ideally, the treatment of this type of schizophrenia should be a multidisciplinary treatment, including a pharmacological and psychological or psychotherapeutic approach. In fact, Its treatment will be similar to that of schizophreniaalthough with its pertinent adaptations.

At a pharmacological level, typical and atypical antipsychotics are used.. Regarding psychotherapy, very varied techniques are used, such as:

Individual therapy (especially from a cognitive-behavioral orientation): its objective is to improve the patient’s functioning, as well as their mood.Family therapy: includes psychoeducational guidelines, and aims to improve the dynamics that occur within the family.

As we have seen, residual schizophrenia is part of schizophrenia, and occurs in the stage where the flowering symptoms are more subdued. From clinical psychology, it will be advisable to conduct a good clinical interview and know in depth the characteristics and needs of the patient, in order to design an appropriate and personalized treatment for each case.

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