We have already spoken more than once about the individuality of the clinical picture in each specific case of schizophrenia. This greatly complicates the diagnosis and can sometimes lead even an experienced doctor into a dead end. Despite this, over decades of work and constant observation, psychiatrists have been able to distinguish three main stages in the development of the disease. To one degree or another, they are all traceable even in polar opposite particular cases of the manifestation of the disease. We will talk about each of the stages separately, so that it would be easier to trace the patterns that determine the course of schizophrenia and the factors that are triggers for pathological processes.
Schizophrenia: prerequisites for classification
A consistent, regular change in psychopathological conditions and syndromes is associated primarily with endogenous causes and cannot be considered as a rigid classification, since the significance of exogenous factors cannot be assessed in the abstract.
By the way, it was the combination of endo- and exogenous factors that formed the basis of the concept of «Nossos and Pathos», the authorship of which belongs to the domestic psychiatrist, academician A.V. Snezhnevsky. According to his theory, the roots of the disease should be sought, first of all, in the patient’s family, the events of his life. In fact, this principle is not new. They began to talk about it at the end of the XNUMXth century, however, the clinical knowledge and conclusions in question were not systematized and received a full scientific justification only in the works of Snezhnevsky, who supplemented them with research results and data from pathophysiological laboratories.
Before the onset of illness
The first bells, barely noticeable to an inexperienced «viewer», form the so-called initial or early stage of schizophrenia. In fact, it is not yet a disease, but it is no longer a health. Its source is the unfavorable climate in the family where the patient was brought up. Often other family members who also suffer from various kinds of deviations can serve as the cause of the manifestation of schizophrenic disorder. And in such a family, where manifestations of schizophrenic disorder become almost the norm, it is difficult to grow up completely normal.
Prodromal stage
Features of the childhood period, family relationships and personal development in adolescence are one of the important markers for making the correct diagnosis. Without a “problem” childhood, the same set of symptoms can easily characterize, for example, neurotic disorders, hypochondria, depression, stress, and even character accentuations.
The period of development of the disease in the initial stage has a rather large time range — from two to several decades. It is difficult to determine the time of the disease, since at the first stage the disease almost does not manifest itself, proceeding unnoticed by others and even by the patient himself. The list of the most likely characteristic signs of the prodromal stage includes:
- pronounced isolation, refusal to communicate with other people;
- “falling out” of reality and constant withdrawal into the inner world;
- lack of interest in social interaction;
- depression and emotional instability;
- inadequacy of behavioral response, hysteria;
- lack of emotion, low emotional intelligence;
- breaking emotional ties with others.
It is in the family that the so-called schizophrenic defect is initially formed, which characterizes the pathology of the individual. But, as a rule, the process goes unnoticed, and disturbing symptoms are mistaken for a complex character, nervous breakdowns, and a post-stress reaction.