What is the course?

At the beginning of schizophrenia there is the so-called prodromal phase in which for about 5 years rather unspecific negative symptoms are present and can be seen as a “warning”. They usually increase in strength over time. After that comes the psychotic phase with more and more positive symptoms such as hallucinations or perceptual disorders that go beyond normal sensory perception.

The hospital is usually not visited until about a year after the first manifest psychosis has occurred. The longer this phase lasts until therapy, the worse the prognosis is usually. The worst case scenario is chronic psychosis, in which there are more and more often psychotic episodes that cannot be controlled without medication.

If the schizophrenia is well adjusted, new episodes can still occur, but many patients or their relatives know about it and go to hospital. In the worst case, the police may take the patient to a psychiatric hospital, as either criminal offenses, suicidal behavior or other behavioral patterns make the police officers prick up their ears. People who have been struggling with the disease for a long time or who often have acute episodes and are overtaxed on their own can also be supported by a caregiver who either has complete or selected rights of determination or can only assist with visits to the authorities and the like, as this is often very stressful and confusing.

The more frequent the acute psychoses are, the more difficult it is for those affected to cope with a regulated everyday life without help. If therapy is started early, such severe courses can usually be contained. The course of the disease, however, varies from person to person and depends on the conditions and the insight into the disease.

Duration

Depending on how many episodes preceded, how quickly treatment is given and what the trigger was, the duration of a schizophrenic episode can vary greatly. Furthermore, it must also be taken into account that the patient must be open to therapy and therefore there should be an understanding of the disease. An often underestimated aspect is the positive influence on the success of therapy through a supportive social environment of friends and family.

In order to be diagnosed with schizophrenia, the symptoms must last at least 1 month. Hallucinations, delusions and other phenomena can occur either intermittently for a few hours or days or permanently during an acute phase. Without timely treatment it may even happen that no improvement occurs and the psychosis becomes chronic. Therefore, it is not possible to make a blanket statement about the duration of a schizophrenic psychosis. Sometimes a residue of negative symptoms remains after the psychosis, which is also called schzophrenic residue.