Information for relatives of schizophrenic patients -1

What is schizophrenia?

Schizophrenia which is a serious brain disorder, is treatable. During the progress of this disease in which the patients link to reality is affected to varying degrees, a marked deterioration takes place in the patient’s thoughts, beliefs, perception and behaviour.

How do symptoms of schizophrenia develop and how do they progress?

If schizophrenia develops over a long period of time (over months) the first signs of the illness may not be noticed or may be ignored by the patient’s relatives. In some people the onset of the illness is sudden (within days-weeks). In such cases the symptoms of the illness are much more varied and marked, reducing the risk of the illness going unnoticed. Symptoms of schizophrenia can vary from patient to patient, and we can see different symptoms in the same patient during different periods. The onset of schizophrenic symptoms has 3 main stages. It should be remembered that the duration of these can vary from patient to patient.

1. Prodrome (initial mild symptoms during the start of the disease)

At this stage the symptoms of the disease are mild enough to go unnoticed. Changes occur in the way the person expresses his or her emotions and thoughts, and some changes can be seen in the behaviour patterns. The person can be irritable, more anxious, joylessness, lose interest in things, become introverted, and develop obsessions. There may be a drop in academic success or failures in the person’s professional life. At first glance schizophrenia resembles many other psychiatric illnesses.

2. Acute exacerbation period

During this phase we encounter what is called psychotic symptoms, like hallucinations (false emotional perceptions), delusions (false beliefs that are held with strong conviction), strange speech and strange behaviour. These are signs that the person is losing touch with reality. The above symptoms can occur all at once in the schizophrenic patient, but it is also possible that the patient only develops one or a few of these symptoms.

3. Recovery period

This is the stage where patients can recover if treated. The level of recovery varies from person to person. With treatment, some patients recover after only one acute exacerbation period and the illness does not recur throughout their lifetime. However, these cases are only 10-20% of all schizophrenic cases.

More often the illness takes a course where recovery and acute exacerbation periods of the illness follow each other. With the appropriate treatment the number of acute exacerbation periods and the strength of the attacks can be reduced. Some schizophrenic patients can have complete or almost complete recovery during the recovery period, others will have only moderate or slight recovery.

In fact, a large percentage of schizophrenic patients (60-70%) have more than one acute exacerbation period, and improvements in their functionality and ability to return to a normal life during the recovery period is only moderate.

In 10% of schizophrenic patients however, in spite of all kinds of treatment, the progression of the illness remains severe with little or no response to treatment.