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Patients who suffer from schizophrenia go through phases where their symptoms are less obvious. In this lesson, we’ll look closely at the three phases of schizophrenia and the symptoms that are common in each phase.

Phases of Schizophrenia

Imagine that you’re standing in a field surrounded by a forest. It is spring, and all of the plants and trees are just beginning to come alive. Baby shoots of pale green surround you, and the smell of fresh grass and plants fills the air.

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Now imagine you stand there so long that spring passes and summer comes into full swing. The trees are darker green now, and flowers are in full bloom, with a mixture of many different colors. Bees buzz around, and the warmth of the sun pounds down on you and everything in the meadow.But as you continue to stand there, the landscape changes again, as autumn moves in. The trees change color to red and gold, and eventually they lose their leaves altogether.

The flowers die, and the ground becomes covered with snow.Just like the seasons, the psychotic disorder of schizophrenia goes through different phases. Schizophrenia is characterized by hallucinations, delusions, disordered thoughts and loss of motivation and emotion, among other symptoms. It has three main phases: prodromal, active and residual.Let’s look closer at each phase and some of the symptoms present at different times during the course of the illness.

Prodromal Phase

The prodromal phase of schizophrenia is the beginning phase. Think of it like spring: the symptoms are starting to show, but they are still ‘baby’ symptoms and aren’t full-blown yet.Most of the symptoms that show up in the prodromal phase are the non-psychotic symptoms. People in this phase often begin to isolate themselves.

They might lose interest in activities and people that they liked before. They also often display less emotion or sometimes inappropriate emotion. Sometimes, people who seemed smart before don’t have the same intellectual capabilities. Motor deficiencies also might show up, mostly in the form of people being clumsy.Let’s look at a case study example.

Sandy is in the prodromal phase of schizophrenia. She used to be social and have lots of friends, but lately all she does is hang out in her room alone. She doesn’t want to do the things that she used to do, and she doesn’t seem to get upset or feel happy ever. In fact, her family notices that she seems almost robotic because she just doesn’t show emotion.

Her grades have fallen, and she seems to be clumsier than usual, too.Does Sandy’s doctor diagnose her with schizophrenia? Well, that’s unlikely at this phase. After all, the symptoms of the prodromal phase, including the ones Sandy is showing, could be part of another disorder, such as depression or bipolar disorder.Despite the difficulty of diagnosing during the prodromal phase, the prognosis for a schizophrenic is much better if it’s diagnosed early. Some doctors might diagnose during the prodromal phase if there are other close relatives with schizophrenia. For example, if Sandy’s twin sister Mandy has schizophrenia, the doctor might diagnose schizophrenia since the chances are much higher that it is.

The prodromal phase can last anywhere from weeks to months. In some people, the symptoms of the prodromal phase even show up in early childhood, even though they do not move into the active phase until their 20s.

Active Phase

After the prodromal phase, schizophrenics move into the active phase, or acute phase. This is like summer: the symptoms of schizophrenia are in full bloom.

When people think of schizophrenia, they are thinking of the active phase.During the active phase, psychotic symptoms become obvious. Patients suffer from hallucinations and delusions and might have disordered thinking or serious motor dysfunction.As Sandy moves from the prodromal phase into the active phase, her family notices that she begins to talk to someone who isn’t there. Sandy is hallucinating a woman, Rose, who is a mother figure to Sandy. Sandy listens to Rose and has long conversations with her.

Among other things, Rose tells Sandy that her family is trying to kill her. Sandy comes to believe this, and even though there’s lots of evidence that it isn’t true, her delusion persists.Sandy and other patients in the active phase of schizophrenia are often treated with medication and therapy. If the symptoms become bad enough, hospitalization might be required.The first active phase of schizophrenia usually happens in the late teens or sometime in the 20s. Some patients only have one active phase in their life, but more often there are several active phases and times in between where symptoms are not as bad.

Residual Phase

When the symptoms ease up and Sandy leaves the active phase, she is said to be in the residual phase, which is similar to the prodromal phase.

Think of this like autumn or winter: the symptoms aren’t as obvious, but the disorder is still there, just like the trees are still a part of the forest, even when their leaves are gone.In the residual phase, Sandy and patients like her no longer experience hallucinations. But she still doesn’t experience strong emotions, and even though she realizes that her family is not trying to kill her, she still thinks that they don’t like her.When a patient enters the residual phase, it is important that they continue with their treatment in order to try to lessen or avoid another active phase. Unfortunately, many patients in the residual phase have a tendency to stop their treatment.

Lesson Summary

Schizophrenia, a psychotic disorder, has three major phases. The prodromal phase is the beginning of the illness.

The symptoms during the prodromal phase are not very strong and might be indicative of other disorders, which is why it is hard to diagnose schizophrenia during the prodromal phase. During the active phase, the symptoms are acute and include hallucinations and delusions. Many patients experience several active phases during their life, interspersed with residual phases, when the symptoms ease somewhat. The residual phase resembles the prodromal phase in the severity and type of symptoms.

Learning Outcomes

After seeing this video lesson, you should:

  • See that schizophrenia has three phases
  • Understand that the prodromal phase is often misdiagnosed as depression or bipolar disorder
  • Know that the active phase brings out the hallucinations and delusions
  • Realize that during the residual phase, the symptoms ease somewhat

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