Symptoms are most severe and pronounced in the acute phase of schizophrenia.
Schizophrenia is a chronic mental health condition impacting millions of people around the world. When active, the condition impairs a person’s thoughts, feelings, behaviors, and perception of reality.
Individuals with schizophrenia often move through three consecutive phases:
In the acute phase, the symptoms are active and noticeable. These symptoms often include the most well-known signs of schizophrenia, including hallucinations, delusions, and atypical behaviors.
In medical terminology, “chronic” refers to a long-term illness, while “acute” refers to more severe symptoms with a sudden onset.
In general, schizophrenia can be both. It’s considered a chronic condition with an acute phase.
During an acute phase, you can experience the most severe symptoms of schizophrenia, such as hallucinations and delusions.
The onset of acute schizophrenia may be different in men and women. The acute phase often begins between 18-25 in men. In women, onset has two peaks: mid-20s to mid-30s and after age 40.
Schizophrenia symptoms vary widely from person to person and fall into the following domains:
- positive symptoms
- negative symptoms
- cognitive symptoms
Positive symptoms “add” to your personality behaviors that weren’t there before, including:
- feeling (tactile)
- smell (olfactory)
- taste (gustatory)
- delusions: fixed false beliefs
- disorganized thinking or speech:
- incoherent speech, “word salad” (random words and phrases strung together)
- pressured speech (speaking rapidly)
- abnormal behavior: odd behaviors such:
Negative symptoms reduce or “take away” from your personality, particularly in:
Negative symptoms involve five key areas:
- fewer words spoken (alogia)
- reduced experience of pleasure (anhedonia)
- withdrawing from social activities (asociality)
- reduced goal-directed activity due to less motivation (avolition)
- difficulty expressing emotions (flat affect)
The cognitive symptoms of schizophrenia can be quite debilitating and often lead to disability.
Cognitive symptoms may include the following:
- memory challenges
- rigid thinking
- lack of focus and inattention
- reduced processing speed
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), a diagnosis of schizophrenia must include at least two of the following symptoms:
- disorganized speech
- negative symptoms
- severely disorganized or catatonic behavior
One of these symptoms must be delusions, hallucinations, or disorganized speech. The symptoms must frequently occur for at least one month, with some lasting more than 6 months.
Diagnosis will also screen for impacted personal relationships, work, or self-care.
When people seek treatment for schizophrenia, they’re usually in the acute phase of the disorder when their symptoms are most active and pronounced.
Though there’s no cure for schizophrenia, treatment can help you move into the recovery phase. The goal is to manage symptoms well enough so that you experience few-to-no positive symptoms and minimal life interference.
Research shows that symptom remission is possible in 20-60% of those with schizophrenia. Early intervention is linked to better long-term outcomes.
Atypical antipsychotics are the first line of treatment for schizophrenia. These drugs emerged in the 1980s as a safer alternative (fewer side effects) than the older generation of antipsychotics.
For the most part, atypical antipsychotics have replaced the first generation, though the older drugs are still used for some people with severe psychosis.
Atypical antipsychotics reduce symptoms of psychosis by acting on the brain’s dopamine system. They may also block a serotonin receptor (5HT2a), allowing for a better balance of dopamine in the brain overall.
Atypical antipsychotics are quite effective for many people; however, about
These drugs are ineffective for schizophrenia’s negative symptoms. In some cases, they can worsen symptoms.
These medications are available in tablets, solutions, and longer-term injections.
Folks with schizophrenia can have difficulties working, socializing, and living independently.
Numerous psychosocial therapies are available to help those with schizophrenia with everything from:
- the ability to think
- money management
- dealing with criticism
Some of the most common therapies include:
- social skills training: improve social and independent living skills, such as money or medication management
- cognitive remediation: improve and train memory, attention, and problem-solving so you can function better in everyday life
- cognitive behavioral therapy (CBT): identify and change inaccurate thinking patterns and behaviors
- social cognition training: improve social skills, such as understanding social and body clues and recognizing other people’s emotions
Schizophrenia is a complex mental health condition that involves three consecutive phases:
- prodromal (early)
- acute (active)
- residual (recovery)
The acute phase involves the most well-known symptoms of schizophrenia, such as:
- disordered thoughts and behaviors
These symptoms are more active and pronounced than in the other two phases.
With atypical antipsychotics and therapy, folks with schizophrenia can manage acute symptoms and live fulfilling lives.