Type of course and prognosis for paranoid schizophrenia

Symptoms of paranoid schizophrenia

Among the main symptoms of the disease are:

• Auditory hallucinations. It seems to a person that thoughts are being instilled in him at a distance, that pseudo-voices are discussing how he behaves, commenting on his actions. The voice can come from different parts of the body.
• Paranoid syndrome. The patient is tormented by delusional ideas, among which persecution mania prevails. He believes that someone is controlling and manipulating him. Moreover, all pathological feelings and thoughts are as real for him as for a healthy person - the ordinary world.
• The patient suffers from affective disorders. In addition to the fact that a person has obsessive ideas, he can be confident in his own omnipotence, in the fact that he was created to control the world, God, the solar system, etc. These thoughts are often expressed in conversations with other people. The patient claims that he is able to change the climate, make life wonderful, and create heaven on earth. The patient's mood can vary from elated to manic. He believes that he is always at the epicenter of grandiose events, great discoveries.
• Kandinsky-Clerambault syndrome is often observed, when the patient believes that someone is controlling and manipulating him. He, in his opinion, is a puppet controlled by higher powers, aliens, etc. He often speaks about this with great conviction.
• Speech disorders and emotional disorders are mild. Sometimes they are completely absent, especially in the initial stages. However, as the disease progresses, emotional and volitional disturbances begin to increase.
• Catatonic symptoms are observed, among which the most noticeable are: affective behavior, silent agitation, catatonic stupor. However, these symptoms are not dominant.
• The patient may also exhibit symptoms characteristic of flattened affect. He becomes insensitive, cold, and does not show any emotion towards the suffering of loved ones.

As for delusions, several varieties are often observed at once, for example, delusions of grandeur are combined with delusions of persecution. Often such patients are incredibly religious.

Types of disease progression

There are 3 main types of disease:

• periodic;
• continuous;
• paroxysmal-progressive.

Additionally, depressive-paranoid schizophrenia is distinguished, in which the signs of the underlying disease are combined with a depressive syndrome. There is also a malignant form. It is characterized by a rapid course and the rapid appearance of pronounced mental abnormalities. Treatment in such cases is difficult. The development of irreversible deviations is possible.

The periodic type of flow is the easiest. In some cases, people have only 1-2 attacks in their entire lives. Severe forms are detected more often. The paroxysmal course is characterized by alternating periods of remission and exacerbations. The longer a person remains in a normal state, the more pronounced deviations may be in the future.

The continuous form is also called chronic. It is characterized by the constant presence of symptoms. Their severity varies depending on the patient’s condition and the stage of the pathology. Due to the absence of periods of remission, disturbances in the perception of the world and thinking disorders occur.

Causes of paranoid schizophrenia

Since there is still ongoing debate about what causes schizophrenia, it is not yet possible to say with 100% certainty about the reliability of any of the reasons.

However, among the most likely factors influencing the formation of paranoid schizophrenia are the following:

• Heredity. The risk of getting the disease increases to 12% if close relatives have a history of schizophrenia. However, many scientists argue that there are other factors in the formation of the disease, besides genetic predisposition.
• Disorders of intrauterine development as a result of exposure to infections suffered by the mother.
• An imbalance of chemical processes occurring in the brain associated with disruption of various receptors. If earlier scientists believed that the development of the disease is influenced mainly by disorders of dopamine production, now the role of such neuromodulators and their receptors as: norepinephrine, acetylcholine, glutamate, serotonin is not denied.

Most scientists are confident that several theories underlie the development of schizophrenia, so it is necessary to create a comprehensive model of the etiology of the disease that would combine neurochemical and neuroanatomical theories together.

Diagnosis of paranoid schizophrenia

General criteria for schizophrenia are used to make a diagnosis. The doctor must identify episodes of obvious hallucinations or delusions, and record emotional, volitional and speech disorders. As a rule, hallucinations that indicate paranoid schizophrenia boil down to the fact that the patient hears a threatening or commanding voice, or a hum, laughter and whistling.

The presence of delirium is mandatory for patients:

• Greatness;
• Impact;
• Harassment;
• Noble origin;
• Special purpose, etc.

The doctor should exclude possible drug-induced and epileptic psychoses, since their symptoms are similar to paranoid schizophrenia.

Folk remedies

You can improve your condition using traditional methods. It is important to use them correctly and consult with your doctor in advance to eliminate the risk of exacerbation or deterioration in well-being.

1. Olive oil. You need to rub your head with oil for about half an hour every other day for a month. According to Tibetan recipes, the oil must first be stored in a clay jug buried in the ground for at least six months.
2. Baths with aspen leaves. You need to throw fresh aspen leaves into a warm bath, let them brew a little and lie in it for 20 minutes. You can repeat the procedure every day.
3. Herbal teas. Plant components calm the human nervous system, giving the body the necessary vitamins. Drinks made from chamomile, coriander, zyuznik or rye are recommended.

Additionally, it is recommended to sew hop cones mixed with lavender into the pillow. Regular inhalation of their aromas has a calming effect and helps suppress the last manifestations of a fading disease.

The paranoid form of schizophrenia causes a lot of unpleasant symptoms that completely cancel out a full life and exclude the patient from being in society. The disease develops over many years, becoming more and more pronounced. The sooner treatment is started, the greater the chances of recovery and long-term remission. But even then, special attention to health and taking light medications, combined with mandatory rehabilitation conditions, will be required.

Paranoid schizophrenia is a form of mental disorder characterized by symptoms such as delusions, hallucinations, and disturbances in perception of the world. The disease may be accompanied by other classic signs, but they are not the main ones in the clinical picture. Depending on the dominant symptoms, the course of the paranoid form can be hallucinatory or delusional.

Treatment of paranoid schizophrenia

In order to prevent the disease from progressing for as long as possible, it is necessary to implement three directions in treatment: drug therapy, psychotherapy and rehabilitation measures.

Drug therapy

Includes taking antipsychotics, which are prescribed by a doctor. In modern psychiatry, both typical antipsychotics and atypical ones (new generation drugs) are used. If classical drugs are aimed at blocking dopamine receptors, new antipsychotics regulate the functioning of seratonin receptors to a greater extent. As a result, it is possible to avoid many side effects, improve the patient’s cognitive abilities and have an antidepressant effect. Classic antipsychotics include Haloperidol, Aminazine, Tizercin (Levomepromazine), and atypical drugs include Clozapine, Aripiprazole, Amisulpride, Olanzapine and others.

In addition, a new class of antipsychotic drugs is used - partial agonists. They are able not only to lower the level of endogenous dopamine, but to regulate it: block or activate it. Among such drugs are Ziprasidone, Aripiprazole.

Taking medications is not limited to hospital settings. The patient should receive them at home, as needed. When the acute stage is eliminated, the doctor will determine the optimal maintenance dose, which will allow for the prevention of possible relapses and the development of the defect.

On the subject: Complete list of medications used for schizophrenia

Psychotherapy

It is aimed at ensuring that close people of a person with schizophrenia can understand and accept the unusual state of the person’s psyche as much as possible, so that it is easier for them to cope with stress, so that they can provide him with at least minimal independent help. Psychotherapy is an important stage in the fight against the disease, but to achieve maximum effect it will require close interaction in the structure: “family + patient + doctor.”

Patients are in dire need of empathy from the people around them and their support. Therefore, understanding and satisfying the patient’s social needs contributes to his maximum adaptation and reduction in the level and number of exacerbations. Taking individual, family, group and other types of classes will not only allow you to better understand and accept the condition of a sick person, but also enhance the effect of drug therapy.

It is important not to try to dissuade the patient that his hallucinations are unreal, this will only push him away and make him more withdrawn. At the same time, one cannot agree that they are real. Finding a compromise is what needs to be done first. It is necessary to make it clear to the person that everyone has their own point of view on this matter, and it should be respected.

Rehabilitation activities

Rehabilitation techniques are aimed at helping the patient adapt as much as possible after suffering an exacerbation of the disease. You should start as early as possible, immediately after the patient returns from the clinic, this will enable rapid social adaptation and allow you to quickly return to normal life. This is why family and individual counseling by a psychotherapist is so important.

Among the effective trainings, there are: trainings on self-esteem, communication, independent living. Individual psychotherapeutic treatment is aimed at constant interaction between the patient and the doctor, conducting conversations on topics that concern the patient, discussing current problems, and jointly searching for solutions. Only in this way will it be possible to establish a strong connection between the patient and reality and develop in him a desire to preserve it. In addition to a psychotherapist, psychologists, social workers and, of course, close people can come to help in the rehabilitation of a patient with schizophrenia.

Prognosis of paranoid schizophrenia

There are certain factors that indicate a favorable prognosis for the course of the disease. If the patient is female, if his family history is not burdened by this disease, if the onset of the disease was acute and not hidden, then the prognosis for the course of paranoid schizophrenia is positive.

Sluggish manifestation of the disease, male gender and the presence of another patient in the family with a similar diagnosis make the prognosis less favorable.

In many ways, the severity of the disease is influenced by timely medical care, as well as the support of loved ones and society. Studies have shown that a negative attitude towards the patient’s personality on the part of society, critical statements, hostility, and attempts to forcibly control a person’s life lead to an increased risk of relapse of the disease.

Author of the article:

Sokov Andrey Vladimirovich |
Neurologist Education: In 2005, she completed an internship at the First Moscow State Medical University named after I.M. Sechenov and received a diploma in the specialty “Neurology”. In 2009, she completed her postgraduate studies in the specialty “Nervous Diseases”. Our authors

Along the way, the following types of this disease are distinguished:

Continuous form of paranoid schizophrenia. Symptoms of the disorder begin imperceptibly in the form of the presence of “strange ideas”, “eccentricity”, isolation and immersion in one’s inner world.

Gradually, over the years, thinking disorders intensify, delusional judgments are formed, and due to inappropriate behavior, the sick person loses his job, friends, and his family may fall apart. As a rule, with this form of the disease, the initiators of contacting a doctor are the patient’s relatives, since paranoid schizophrenia is characterized by a lack of criticism of the condition, that is, the sick person does not feel or understand that he is sick.

In advanced cases, it is necessary to resort even to involuntary hospitalization (according to the “Law of the Russian Federation on Psychiatric Care.”), since due to illness, patients may stop eating, taking care of themselves, and intend to commit acts dangerous to themselves and others. Although, most often, with proper motivation, the patient can be convinced to see a doctor and begin treatment.

Paroxysmal form of schizophrenia (fur coat-like schizophrenia). This form of schizophrenia is characterized by acute psychosis in the form of abnormal behavior with delusions and hallucinations, agitation and aggression, sleep disturbances and even fever. After the symptoms of psychosis are relieved, orderly behavior returns, but after some time, the psychosis recurs.

Over time, the “bright intervals” between psychoses can shorten, and the patient himself, even during the periods between psychoses, becomes withdrawn, passive, and emotionally cold.