What is the course

The course of the schizophrenia is divided into three different episodes in order to gain a better understanding of the course. However, these can be very individual for each patient and can occur at different speeds. The first symptoms that appear in the course of schizophrenia are assigned to the so-called preliminary phase, also called prodromal phase.

The spectrum of symptoms in this phase usually includes a loss of interest, emotional instability and general tension. In most cases, the onset of the first delusions is followed by social withdrawal on the part of those affected. Subsequently, the symptoms usually increase further and the phase of the so-called acute phase is reached.

In this stage, the positive symptoms, such as hallucinations, are usually fully developed. Often a persecution mania is also part of the symptom spectrum. At this stage, the disease is diagnosed in most cases.

In this phase, patients show a significantly increased risk of suicide. The phase of the acute attack is, as the name suggests, usually relatively short. This is followed by a slight flattening of the symptoms in the transition to the chronification phase.

However, even after the acute attack, the disease may subside almost completely. This is the case in about 25% of those affected. Chronification usually focuses not only on acute phases but also on negative symptoms such as loss of interest, fatigue, lack of emotion and lack of drive.

About 25-30% of all patients suffer from the symptoms of schizophrenia for the rest of their lives. It must be emphasized that the different phases can be of different length and intensity in each patient. It is also possible to remain in one phase.

What is the long-term prognosis?

The long-term prognosis for schizophrenia is generally considered mixed. Although up to a third of all patients can be cured of the symptoms of schizophrenia, even these patients can still feel the effects of the disease many years later.These include a significantly low earning capacity, a restriction of memory functions and social skills as a result of the disease. In addition, there is always the risk of a relapse.

However, the consistent continuation of a drug therapy can drastically reduce the risk from 85% to 15%. Another prognostic factor is the exact form of schizophrenia. Thus, patients suffering from paranoid schizophrenia with persecutory delusion have the best prognosis of all schizophrenia patients. However, if the psychosis remains untreated for a long time, a significantly worse development can be assumed. This includes social isolation, lower chances of recovery and a higher risk of developing addiction.