RESIDUAL SCHIZOPHRENIA: Symptoms, Causes and Treatment

In the medical field, it is essential to make an adequate diagnosis, to later be able to elaborate the prognosis and treatment at a determined disease, for this reason the need arose to establish diagnostic classifications and subclassify the different patients in said categories. Faced with the great heterogeneity that schizophrenic disorders present, the need to establish subtypes of schizophrenia in function of its clinical manifestations, giving rise to: disorganized, paranoid, catatonic, undifferentiated type schizophrenia and residual. In this Psychology-Online article, we will expose the different clinical subtypes of schizophrenia, focusing on the Residual schizophrenia: symptoms, causes and treatment.

Index

1. Types of schizophrenia
2. Residual schizophrenia: symptoms
3. Causes of residual schizophrenia
4. Treatment of residual schizophrenia

The diagnosis of a certain subtype of schizophrenia is established based on the manifest characteristics and the predominant associated symptoms presented at the current time of evaluation, therefore the subtypes can change over time, the same person being able to present different symptoms and change the subtype of schizophrenia throughout the evolution of the disease.

Among the subtypes of schizophrenia we find disorganized, paranoid, catatonic, undifferentiated and residual schizophrenia. According to the Diagnostic and Statistical Manual of Mental Illnesses (DSM-IV), the characteristics of each of the types of schizophrenia are:

1. Disorganized schizophrenia

In the subtype of disorganized or hebephrenic schizophrenia the main characteristics of symptomatological presentation are:

• Disorganized language, which may be accompanied by behaviors disconnected from the content, such as nonsense or laughter.
• Behavioral disorganization, which can interfere in the performance of activities of daily life (dressing, hygiene, preparing food, ...), as well as behaviors such as lack of orientation towards a goal. Flattened or inappropriate affectivity predominates.

2. Paranoid schizophrenia

The diagnosis of the type of paranoid schizophrenia is marked by a high prevalence of positive symptoms, with the presence of clear delusions or auditory hallucinations. However, there is a preservation of cognitive and affective capacity, so that there are no negative symptoms of the disease and if they are present, they are not very marked.

3. Catatonic-type schizophrenia

The main characteristic of this subtype is based on a marked psychomotor disorder. Being able to manifest:

• Immobility motor due to catalepsy.
• Excessive motor activity, which may require supervision to avoid harm to self or others.
• Peculiarities of involuntary movement, such as taking strange or inappropriate postures.
• Extreme negativism, presented as a resistance towards all orders or in maintaining a rigid posture in the face of the attempt to be moved or silence.
• Echolalia or echopraxia

4. Undifferentiated schizophrenia

This type of schizophrenia is established when the patient meets criteria A for the diagnosis of schizophrenia (delusions, hallucinations, disorganized language, catatonic or disorganized behavior and negative symptoms such as affective flattening or apathy), but criteria for other types are not met and the diagnosis of the paranoid, disorganized or catatonic subtypes cannot be established as a diagnosis.

5. Residual schizophrenia

This subtype of schizophrenia should be used in the presence of at least one episode of schizophrenia, without current clinical picture, the existence of positive psychotic symptoms appears present and if they appear, they do so in a very dimmed. However, there is a continuous manifestation of negative symptoms.

What are the symptoms of residual schizophrenia? This subtype of schizophrenia manifests with the attenuation of positive symptoms referents of schizophrenia and a high presence of negative symptoms. For the correct diagnosis of residual schizophrenia, the following criteria must be met:

1. Absence of delusions, hallucinations, disorganized speech, and catatonic or severely disorganized behavior. If these are presented, they do so in an attenuated way, expressing rare beliefs or unusual perceptual experiences.
2. Continuous manifestation of negative symptoms and alteration. Being able to present:

• Affective flattening. This symptom of residual schizophrenia means the null reaction to emotional stimuli, resulting in a reduction in the intensity of emotional expression.
• Praise. Another symptom of residual schizophrenia is poor speech, including decreased fluency in speech. Language in schizophrenia it has many peculiarities.
• Apathy or apathy. That is, lack of will, inability to persist or to start an activity. Feelings of emptiness can occur.

The course of residual schizophrenia can present with a limited time, representing a transition period between an acute episode and the total remission of the disease. However, its manifestation can persist over the years, with or without acute episodes occurring.

Although at present an associative concept to the cause of schizophrenia has not been established, it is known that there is a high genetic vulnerability, which implies a greater probability of manifesting the disease if a relative has developed it, however it is not a fair condition. In addition to the genetic predisposition presented, it is related to the presence of stressful life events, that carry a high emotional load. However, none of the causes has been proven to be an empirical reality and research is ongoing.

On the other hand, the possible causes for the development of one subtype or another of schizophrenia have not been determined. To a certain extent, it is because the types of schizophrenia can be very labile, being able to present different subtypes during the course of the disease. For this reason, the causes of residual schizophrenia are empirically unknown.

Here you can see how schizophrenia is diagnosed.

First of all, it should be mentioned that schizophrenia is a serious and chronic mental disorder. Therefore, all subtypes of schizophrenia require a long-term treatment, and in many cases it can be a treatment that accompanies the person throughout life, without the need for the presentation of symptoms.

The treatment of this disorder tends to begin with psychiatric discipline, with the antipsychotic drug, which helps control the positive signs and symptoms of the disease. Antidepressants and anxiolytics They are also used for their intervention to alleviate the negative symptoms and anxieties generated by the diagnosis of the disease. Even so, the unique work with this discipline does not allow its complete remission, since the most important thing in the treatment is to execute a multi-disciplinary intervention with the different disciplines in mental health (psychiatry, psychology, social worker, Nursing,…).

After the stabilization of the symptoms, with the administration of psychotropic drugs, the person is ready to start a psychological treatment combined with pharmacological treatment. Psychological treatment has special relevance to be able to carry a good evolution of the disease.

In the case of residual schizophrenia, psychological treatment will not focus especially on awareness of the delusional or hallucinatory content, since it is not manifested actively. However, special relevance should be paid to the negative symptoms presented, such as affective flattening, allogy and apathy. For him psychological treatment Of the symptoms of residual schizophrenia, the most commonly used interventions are the following:

1. Psychoeducation

The psychoeducation of the disease is key for both the patient and her family, in order to provide them with a correct information about the disease, the medications used, the established procedure of the therapy, the awareness of the disease, its acceptance and the correct adaptation to it.

2. Individual therapy

Individual therapy with the patient is very important to help him identify the presentation of the symptoms, and then establish strategies with the aim of stopping the possible relapses. In addition, you are offered strategies to be able to reduce stress and anxiety associated with the disease.

3. Family therapy

Family therapy is especially relevant in the residual subtype of schizophrenia, since there is a high presence of negative symptoms, which can have a strong impact on the relatives. Faced with this, the family's suffering must be welcomed, providing them with the necessary support and providing them with strategies to deal with this situation.

4. Social skills training

Given the number of negative symptoms, social skills training is very important in residual schizophrenia, a technique of cognitive-behavioral therapy, to decrease avoidance behaviors and indifference to the environment. The work should focus on the identification of emotions own, others and their correct contextualization, social interactions and communication.

5. Daily life activities

Due to the impoverishment and deterioration caused by the disease, an intervention should be carried out that aims to acquire the basic habits of daily life, help them find and keep a job, house maintenance, and so on.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Residual schizophrenia: symptoms, causes and treatment, we recommend that you enter our category of Clinical psychology.

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• Alanen, Y. OR. (2003). SCHIZOPHRENIA. Its Origins and its Treatment Adapted to the Needs of the Patient. H. Karnak Ltd: London
• Gastó, C (2007). Schizophrenia and Affective Disorders: advances in diagnosis and therapy. Madrid: Panamerican Medical.