Schizophrenia Prodromal signs

What happens when schizophrenia starts?

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In the last post, we saw how:

  • There is a neuroendocrine aspect to schizophrenia that is not totally confirmed.

  • Paranoid schizophrenia is outdated naiming system for a subbtype of schizophrenia because every trupe of schizophrenia presents with schizophrenia.

  • Therapy in schizophrenia leads to remission in symptoms but there is no cure for schizophrenia

What happens when you have paranoid schizophrenia?


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Welcome to Medic Vibes, where we discuss mental health disorders and make sense of them. Dr Ebingo Kigigha is a medical doctor (aspiring psychiatrist) and creative person (illustration and music). This has been our routine for three consecutive months. This month will be dedicated to Schizophrenia. In the first month, we discussed Depression, and in the subsequent month, anxiety. We just finished with Bipolar affective disorder. We are done looking at research work done in Nigeria on schizophrenia.

In this post, we are looking at a Quora. To learn more just keep scrolling down. You can also skip to the key point of the post if you which or go to the conclusion to get the summary.


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Types of schizophrenia


Undifferentiated Type

Sometimes the types of schizophrenia do not allow for the proper placement of a patient's features. In this case, the patient is said to have an undefined type of schizophrenia.

Residual Type

In this type of schizophrenia, the patine presents with proof of schizophrenia but the symptoms are not clear cut and at the same time it does not fit into any of the other types of schizophrenia. The patient may be distant emotionally, may not socialize with people have bizarre behaviour and may not follow a logical line of thought and may lose touch with reality in a very mild way.

The positive symptoms are also very loosely held. They are no strong-held delusions and hallucinations as seen in other forms of this condition.


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Schizophrenia Prodromal signs


Source

Susan Winlow who attempts to answer the question is a nurse Researcher on Psychotic disorders. She explains that the youngest age is 15 this is when the clinical features begin to emerge. The patient becomes unmotivated. The patient does not take pleasure in previously pleasurable activities. The patient may previously have been the type to enjoy playing volleyball but he or she may feel like it anymore.

The patient starts having abnormal thoughts. The ideas are usually not shared with anyone. They start to lack discrimination in the sound. The fan, fridge, and crickets at the side all sound at the same volume. The patient may not want to spend time around people because of the fear of them being so loud.

The patient may see a line of light passing across their visual field. They begin to hear their name being said in a different direction. These are auditory hallucinations.

The patient started having delusions of people talking badly about them. These thoughts may be thought of they trying to harm them by poisoning their food. These initial delusions are such that the person knows that they are delusional thoughts.

If the patient does not seek help at this point they will stop seeing anything wrong with the thoughts if they do not get help. The patient eventually loses touch with reality and they get fully affected by schizophrenia


According to Medscape, it is hard to diagnose schizophrenia. The main reason is that those who have schizophrenia do not realise that they have an issue.

The second issue mentioned about the early features of schizophrenia looks like normal life occurrences. The patient in their teens may take on new friends and this may be a prodromal phase of the illness, but this may just be like a normal phase in their life.

Some doctors suggest prescribing small doses of antipsychotics and this may push back the presentation of this condition. This has not been done many times are plenty of patients and more studies need to be done to confirm this insurance.
The larger body of scientists agrees that behavioural therapy has better results than medication. In addition, these children should be placed on training for social skills.


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Treatment


Stabilization phase
After the patient receives the acute phase treatment, the patient is supposed to be placed on a 6-month stabilization therapy. When the patient receives this therapy the acute symptoms reduce.

The goal for the patient is to have reduced stress. Another goal is to stop the course of relapse while trying to reintegrate the patient into society. By continuing therapy the patient is also supposed to solidify the remission that was started initially.

The patient is to be closely watched while they receive the same dose that achieved remission in the acute phase. If this dose is reduced too early the patient can redevelop symptoms.

The stabilization phase does not require so much adherence to literature, when compared to the acute phase, at this point it is more important to reeducate the patient and inform them about their treatment and the course it will follow.

The patient needs to learn details about taking care of the condition themselves and how it will benefit them to prevent a relapse. Taking the medication is the best way to prevent this. The patient should also be aware of the side effects of these drugs.

While informing them about the condition they should know when warning signs might be emerging, teaching them to prevent relapse by avoiding alcohol and illicit drugs.

The patient must follow the treatment plan from start to finish (from acute to stabilization. When the patine is also being discharged from the hospital, they should also be prescribed outpatient management.


Questions


  • What did you learn about Schizophrenia?

Conclusion


  • Undifferentiated type of schizophrenia and residual type of schizophrenia are very similar in that they do not fit into the other classes of schizophrenia.

  • The prodromal phase of schizophrenia is hard to diagnose because of the similarity between normal behaviour, especially normal adolescent behaviour.

  • Stabilization phase of schizophrenia is prescribed to prevent recurrence and to keep the patient in normal health.

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References


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