How Does Schizophrenia Start? Phases And Prognosis Of This Disorder
Do you know how it starts and what are the factors that influence its prognosis? Discover the different phases, what your prognosis depends on and how the symptoms begin.
The schizophrenia It is a psychotic disorder that usually seriously impairs the functioning of the person who suffers from it. According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), between 0.3 and 0.7% of the population suffers from schizophrenia.
It has been found that 30% of patients with schizophrenia They present a favorable evolution, with almost no symptoms and good social functioning. On the other hand, 50% present an irregular evolution and the other 20% present a poor evolution with a serious impairment in functioning. This evolution, in many cases, depends on the onset, as well as the functioning prior to the presentation of the disorder. If you want to know how schizophrenia starts its phases and its prognosis, continue reading this article.
Schizophrenia is a type of psychotic disorder that can present with different symptoms and that significantly affects the functioning of those who suffer from it, both socially, at work, academically, in self-care, etc. Specifically, the schizophrenia symptoms It can be divided into two large groups:
Positive symptoms: Positive symptoms refer to those that are more striking, such as, for example, hallucinations the delusions he disorganized behavior, etc. The term positive refers to self-care to symptoms that appear and that were not previously present in the person. Although they cause discomfort, negative symptoms have a worse prognosis since positive symptoms respond better to treatment. Pharmacotherapy
Negative symptoms: The negative symptoms of schizophrenia They refer to those that involve a loss or decrease in normal functions. These types of symptoms are not specific to schizophrenia but are also present in disorders that are not on the psychotic spectrum. These are the ones that have the worst prognosis and negatively affect the functioning person’s diary. Some examples are: anhedonia (decreased ability to experience pleasure), avolition (lack of motivation), etc.
At what age does it start and what is its course like?
Age and form of onset:
The schizophrenia It does not have a specific age of onset but can occur throughout the life cycle, with the most common stages being adolescence and the beginning of adulthood. However, it has been found that schizophrenia tends to appear earlier in men than in women, with the usual age of onset being between 18 and 30 in men and, on the other hand, between 25 and 35 in the case of men. women. In the case of women, it has also been found that there is an increase in cases between the ages of 50, a stage that coincides with menopause.
Normally, at onset of schizophrenia It is associated with a stressful life event that precipitates the onset of the disorder. Schizophrenia It can appear gradually (the symptoms appear little by little and increase in intensity over the years) or appear suddenly, that is, in days or a few weeks.
Phases of schizophrenia:
Schizophrenia is characterized by not having a linear course, that is, the symptoms do not always present with the same intensity. Once diagnosed, it could be said that three can be distinguished. phases of schizophrenia:
Acute phase: This phase is mainly characterized by the presence of psychotic symptoms (hallucinations and delusions, etc.). It is at this time that people suffering from schizophrenia usually have their first contact with mental health services. Once the symptoms typical of this phase are controlled, the people with schizophrenia They go through a period called critical.
Critical period: The critical period is characterized by being the phase after the phase acute and lasts approximately 3 to 5 years. The predominant symptoms are positive symptoms of moderate to severe severity, social isolation, moderate cognitive impairment and symptoms may begin to appear. negative symptoms, but these are usually of low intensity. The symptoms prevent the person from developing in the different areas of their life as they did before suffering from schizophrenia. During this period, people may show improvement, a remission of symptoms, or they may evolve into chronic forms of the disorder.
Subchronic phase: The subchronic phase is mainly characterized because patients present various relapses with positive symptoms These occur especially when the treatment established (although there are people who do comply with it and still have relapses) and tend to evolve into chronic forms of the disorder.
Chronic phase: The chronic phase is when more than five years have passed since the acute phase, they have numerous relapses and serious difficulties in carrying out the activities they previously carried out. In this phase of the disorder there are no longer positive symptoms of such intensity but rather predominates negative symptoms with a serious intensity and that seriously affects the functioning of the person. Some of the symptoms of this phase are: inability to enjoy activities they previously enjoyed, serious difficulties in creating relationships, problems concentrating, lack of energy impoverishment in emotional expression, limitation of thought and language, etc.
Factors that influence the prognosis of schizophrenia:
Different studies have been carried out with the aim of knowing what factors influence the prognosis of the people with schizophrenia, given that some are progressing favorably and others, on the other hand, have great difficulties in being able to resume the activities they previously carried out. In this sense, there are different factors that influence the prognosis, such as, for example, the following:
Premorbid adjustment: The phase Premorbid is the period before the onset of symptoms of a disorder and in recent decades this stage has become especially relevant when it comes to being able to detect early and predict the prognosis of this disorder. Specifically, it has been found that the better the psychosocial, relational and emotional functioning of the person before suffer from schizophrenia the better the prognosis.
Sex: As we have already mentioned, schizophrenia in men usually appears earlier than in women and it has been shown that, usually, the earlier it appears the first episode, the worse your prognosis will be. Therefore, men usually have a worse prognosis than women.
Family history of schizophrenia: If the person with schizophrenia already has first-degree relatives with the same disorder, they have a worse prognosis for development than a person who does not have any. family with schizophrenia
Socio-family support: It has been found that the people with schizophrenia Those who have a consolidated social support network (stable couple, cohesive family, etc.) have a lower risk of relapse and a better prognosis.
Consumption of drugs: The consumption of drugs It normally precipitates the appearance of the disorder in those cases with a predisposition. Furthermore, those people with schizophrenia who consume alcohol and other drugs, need a higher dose of antipsychotics to achieve stabilization, a fact that is related to a worse prognosis.
High degree of psychosocial stress: Some authors refer to the “expressed emotion” in the family environment, which is, basically, a high level of hostility, criticism and emotional overinvolvement of the family with the family. person suffering from schizophrenia The higher it is, the worse the prognosis will be for the person who suffers from it.
Non-treatment time: The longer the time since a person presents the first episode until you receive treatment, the worse its evolution will be. Furthermore, it is common that the longer it takes, the symptoms will be more serious and there will be greater resistance to the effectiveness of the medications. antipsychotics
Number of relapses: The more relapses that occur after the first episode, the worse the prognosis. Furthermore, each relapse leads to further deterioration in the functioning of the person so their improvement will be more complicated.
Starting way: When in the early stages of schizophrenia the positive symptoms They have great intensity and alternate with negative symptoms, they usually have a negative prognosis. It seems that if the negative symptoms occur from the beginning, schizophrenia presents a worse course.
The schizophrenia It can seriously affect a person’s life and that is why, when the first symptoms appear, one should go to a professional as soon as possible so that they can assess what is happening to us and be able to plan a treatment. proper treatment for us.
