Paranoid schizophrenia: causes, symptoms, treatment

Schizophrenia is one of the most complex and mysterious mental disorders. Scientists have been studying it for centuries, but have not been able to understand exactly why it occurs and whether it is possible to get rid of it forever. It occurs in approximately 1 person out of 100. The most common form of pathology is paranoid schizophrenia. In the article we will consider its main features, causes, symptoms and treatment methods.

general characteristics

Paranoid schizophrenia (ICD 10 classification code - F20) is also called paranoid. However, this is more a household name than a medical one. This pathology is necessarily accompanied by delusions and hallucinations. It is especially characterized by delusional disorders, which manifest themselves in various forms.

Because of this disease, a person is not able to adequately assess the surrounding reality, loses touch with reality, but at the same time retains the ability to think. During the period of remission, he is able to lead an almost normal lifestyle.

Paranoid schizophrenia is detected in approximately 1% of people. The first signs, as a rule, make themselves felt at the age of 30. Although there are other types of schizophrenia, for example, moderately progressive, which develop later. In any case, accompanying symptoms may persist for a long time. At the same time, people do not pay attention to them until the first attack, that is, the moment when it is impossible not to notice the “strangeness” in a person’s behavior.

According to statistics, 560-600 thousand cases of schizophrenia are diagnosed annually in Russia. About 85-87% of them are patients with the paranoid form. It is often detected in men. Almost all patients exhibit severe symptoms. Negative symptoms are present in 96%, delusions in 93%, chronic symptoms in 67%, verbal hallucinations in 59% of patients, and catatonic syndrome in 13% of men and 2% of women.

Causes

The main cause of paranoid schizophrenia is a functional disorder of the brain. However, there are a lot of factors that can provoke it. One of the main ones, which scientists usually call, is genetic. In simple terms, the likelihood of developing schizophrenia is higher if there is or has been a history of mental disorders in the family.

Another factor is related to the hormone dopamine. Disruption of its production causes a malfunction in certain areas of the brain, which causes delusions and hallucinations.

Doctors also name risks that could hypothetically provoke symptoms of paranoid schizophrenia:

infectious diseases in pregnant women;
fasting during pregnancy;
constant stress and depression;
psychological childhood trauma;
drug addiction and alcoholism;
head injuries, including birth injuries.

These factors do not always lead to schizophrenia, however, if there is a genetic predisposition, when a person has relatives with similar diagnoses, all risks, especially alcohol and drugs, should be excluded.

What is paranoid schizophrenia

Paranoid schizophrenia is the most common type of illness. Sometimes mistakenly called paranoid schizophrenia. It is manifested by the presence of delusions of persecution, obsessions, conversations with non-existent interlocutors, and problems with self-identification are observed. Sometimes paranoid schizophrenia is accompanied by hallucinations and catatonic symptoms (in a mild form).

The exact causes of the disease have not yet been fully determined. Possible reasons that can provoke hereditary mental disorders are: the influence of the environment, family upbringing, prenatal and stress factors, alcoholism, drug addiction and disorders in the brain (neurobiological factors), age crisis.

Prevention of paranoid (paranoid) schizophrenia

Schizophrenia affects about 10% of the population. The first, pronounced attack often occurs before the age of 30. But early signs and symptoms of paranoid (paranoid) schizophrenia can occur as early as adolescence and young adulthood. Anyone can develop schizophrenia during their lifetime. As the disease progresses, social aspects of life and a person’s functioning in society suffer, which causes the person severe mental discomfort.

Symptoms

The symptoms of paranoid schizophrenia are as varied as any other form. Its stages can be episodic and chronic, remission can be complete or incomplete. Sometimes the disease recedes, but in other cases it develops progressively, leading to the disintegration of personality and consciousness.

The basic symptoms of any form of paranoid schizophrenia are:

Delusions of persecution (criminal, sexual, etc.), jealousy, influence, delusions of grandeur or special purpose.
Hallucinations of a threatening form - auditory, verbal and tactile (less often - visual).
Attacks of senestopathy - painful sensations on the surface of the body or in the internal organs.
Depersonalization is a psychopathological disorder of self-perception.

Affective disorders - bipolar, depressive, inappropriate emotions, etc.
Decreased volitional qualities, lack of initiative, lack of interest in anything.
Cognitive impairment—memory impairment and problems formulating thoughts.

Symptoms are determined by the form and stage. First, primary symptoms are observed, which make it difficult to suspect the disease. Then delusions and hallucinations appear. After this, delusional ideas become fantastic. At the final stage of the disease, complete destruction of the personality occurs.

Causes

Among the main reasons that can provoke the appearance of the paranoid type of schizophrenia are the following:

genetic predisposition. The risk of developing the disease increases in individuals in whose family there have been recorded cases of mental disorders;
physiological disorders of the central nervous system and brain;
regular stressful situations, prolonged mental and psychological stress, leading to exhaustion of the human nervous system.

The paranoid form of mental illness is chronic or episodic in nature, which is accompanied by primary symptoms of the disease.

Schizophrenics, regardless of the form of the disease, are strictly prohibited from consuming alcoholic beverages, narcotic and psychotropic drugs, which can lead to changes in consciousness.

First manifestations

In paranoid schizophrenia, positive symptoms are more often observed than negative ones. This means that delusions, hallucinations and thought disorders predominate, and not apathy and lack of will, as happens with other types of pathology before attacks. At the very beginning, the patient begins to have delusional ideas and thoughts. He may say that he expects something bad, scary or destructive. It happens that he is unable to calm down until, for example, he counts to 100.

Along with such thoughts, hypochondria worries me. A person is very concerned about his health and is afraid of getting sick or infected. Senestopathies often occur when there are unusual and unpleasant sensations in the body: a hoop squeezing the head, stabbing pain in the heart, as if a needle was stuck into it, etc.

At the initial stage of paranoid schizophrenia, a person’s sleep is disturbed, which affects his daytime state. His emotional background is characterized by scarcity and inflexibility, emotions are dulled. He looks like a rigid and uninterested individual who absolutely does not care what happens around him. In this case, aggression towards loved ones is possible. Your social circle is narrowing, and it becomes more difficult to establish relationships with people.

Symptoms depend on each specific case. Some patients, although few, can be violent in the initial stages. They have sadistic tendencies. They abuse animals, especially cats and dogs.

Almost all patients experience increasing fear and anxiety. Because of this, the patient turns into a confused person who cannot fully navigate the new situation. He has difficulty making decisions.

Sometimes the listed signs appear 10 or even 25 years after some injury.

This stage can continue for several years. Gradually, the number of symptoms increases as the pathology continues to progress.

The first signs of schizophrenia in men

How does schizophrenia manifest in men in the initial stages? It is, first of all, expressed in duality in everything - in behavior, emotions, judgments and actions. The patient gradually withdraws from his family and tries to avoid sharing traditional meals and festive events. Over time, he ceases to be interested in the affairs and news that happened in the lives of his household.

The emotional background becomes unstable. It is characterized by contrasting mood changes. A man can tear up while watching a dramatic film, and a minute later shout angrily at his family because of a phrase that he did not like. He perceives news about the death of a loved one with indifference, while he sincerely suffers because of the death of a small fish or indoor flower.

The man’s actions begin to lack logic ; he cannot concentrate for long on completing the task assigned to him - vacuuming, doing his work, preparing for a seminar at the university.

The initial signs are also characterized by a state of passion. A man is overly emotional, overflowing with physical strength, and capable of great accomplishments. However, such moments are quickly replaced by powerlessness, moral decline and oppression. All these symptoms in the behavior of men are difficult to mistake for such a complex disease as schizophrenia. The patient's relatives often attribute them to fatigue, overwork, and nervous tension. The person himself also does not notice the changes happening to him. Meanwhile, the disease is slowly but steadily progressing. Only with the appearance of pronounced signs do relatives begin to see “something strange” in the behavior of their loved one, which was previously unusual for him, and “sound” the alarm.

Paranoid syndrome

Paranoid syndrome is the next stage of paranoid schizophrenia, which is characterized by the presence of a mild form of systematic delusions. This means that the patient can interpret and explain it well. Typical crazy ideas:

Reformative - the patient is convinced that he has invented or created something brilliant that can change the structure of the world.
Erotic - the conviction of the existence of a maniac who constantly pursues.
Belief in one’s own chosenness, high origin, in belonging to the royal family or representatives of “blue blood”.
Kverulyantskie - constant slander, filing complaints and incessantly fighting for their rights.

In paranoid syndrome, delusions are structured and systematized. The patient can logically justify arguments and provide evidence of his theories. He is not tormented by hallucinations or automatisms, so he does not consider himself sick. This aggravates the situation, since he will be met with misunderstanding from people. This will lead to depression and further development of the disease.

Stages of accepting a delusional thought:

Expectation is an internal anxiety, a feeling that something incredible is about to happen.
Insight - suddenly a person understands where his fear comes from, he begins to see everything differently, looks at the world with “new eyes.”
Systematization - everything fits into one picture, which the patient can rationally explain and describe.

If the disease is detected at this stage, a diagnosis of paranoid schizophrenia will be made.

Kandinsky-Clerambault syndrome

The third stage of paranoid schizophrenia is Kandinsky-Clerambault syndrome, named after the Russian psychiatrist and French doctor. It is characterized by the development of several types of automatisms in the patient:

Ideatorial (associative). The patient feels as if someone is putting thoughts into his head. He also suspects that others can hear his thought process. Mentism is observed - a symptom of an influx of thoughts and memories. Often the patient believes that certain events are forcing him to remember outside forces.
Sensory (senestopathic). At this stage, automatisms concern bodily sensations. It seems to a person that they are caused from the outside. Feelings of cold, warmth or excitement, the sources of which, in fact, do not exist.
Motor (kinesthetic). These automatisms are associated with physical activity. Now the patient believes that all his actions are performed not by him, but by someone else, as if any movement is performed without the participation of his will. This especially applies to speech motor movements.

Wizards, aliens, hypnotists, etc. can act as an extraneous force that forces a person to think, feel and act.

At this stage, if hallucinations occur, they are auditory. The patient hears swearing in his direction, comments and commands.

With Kandinsky-Clerambault syndrome, pseudohallucinations are possible, when patients distinguish hallucinations from real objects. Both familiar and unknown people, pictures, voices, etc. appear in visions.

Paranoid delusions

After the paranoid stage, the paranoid stage develops. It is characterized by the formation of unsystematized delirium with various themes. Several unrealistic ideas of different directions appear at once.

Unlike the paranoid delusional concept, which can acquire a logical coloring, paranoid delusion is completely devoid of logic. It is fragmented, episodic, abstract.

Here is the story of a guy suffering from paranoid schizophrenia. The illness made itself felt through delusions of attitude. It seemed to him that they were watching him and collecting information about him of various kinds. At work, the team talks about his personal life, on the street all people look at him.

Then the idea was added that the neighbors below (of Caucasian nationality) wanted to take over his apartment, so the young man quit his job in order to protect his home. He believed that the Caucasians had already installed wiretapping and were watching him. He claimed that they had taken possession of his will, putting pressure on him, inclining him to communicate. If I found a small object, a button or a paper clip in the room, I assumed that the neighbors had installed a bug.

Even a year after the Caucasians moved out, the delirium persisted. The guy was sure that they continued to live secretly in the same apartment. He explained that they went to the magician and showed him his photo. Now this magician guides his thoughts, actions, and instills in him a model of behavior.

The patient treated the head of the Caucasian family with respect. He said that he was a worthy man and even went to his homeland and cut off his finger there as a sign of respect for him. This is a kind of request so that the patient does not resist and gives them the apartment.

Now the guy must also deprive himself of some part of his body as a sign of solidarity. To do this, he tied his big toe with thread, bringing it to gangrene. The organ had to be amputated. The patient thought that the effect on him would stop. However, this did not help. And he decided that, probably, it was too small and insufficient a sacrifice and the left hand needed to be removed. During examination in a psychiatric hospital, a strangulation groove was discovered on his wrist.

The emergence of paranoid delusions indicates a deep damage to the psyche, covering all its layers. Its themes are also varied. Ideas of persecution prevail. There are also delusions of relationships, influence, etc.

In men and women, the disorder has no clear distinctions. But the delusional theme may differ. Thus, women are more likely to obsess over their appearance, family and fertility, while men are more obsessed with thoughts about career, love affairs, spies and criminals.

The paranoid stage of the disease is characterized by impaired perception, manifested by hallucinations, pseudohallucinations, and illusions. Thus, delusional, hallucinatory and delusional-hallucinatory course of the disease is distinguished. The presence of hallucinations softens the severity of the condition and has a more favorable outcome. In this case, delirium develops quickly, and after it is systematized, the patient experiences relief.

Hallucinations at this stage of the disease are mainly auditory. The patient hears voices that call him by name or make unpleasant remarks in his direction, use foul language, and comment on his actions. Then pseudohallucinations occur. They are characterized by the feeling that someone else's thoughts have been introduced into the head. Patients hear silent voices, echoes of thoughts, voice streams from any part of the body or from another planet.

Another symptom of the paranoid stage of the disease is mental automatisms. There are the following types:

motor – patients are sure that someone is directing their movements. They happen by someone else's will. A person walks, talks, smiles under external influence;
ideational – thoughts are put into a paranoid person’s head. Either there is a certainty that his own thoughts are stealing from his head;
sensory - any sensations in the body, natural and unnatural, appear under the influence of magical forces.

Quite often, according to patients, actions, thoughts, and sensations are “imposed” on them by aliens, magicians and sorcerers, or by introducing X-rays or other devices.

Pseudohallucinations, delusions of influence and mental automatisms are combined into one syndrome called Kandinsky-Clerambault. The syndrome is often diagnosed during the course of the disease.

Paraphrenic syndrome

Paraphrenia is the fourth stage of paranoid schizophrenia. It begins to form even at the stage of Kandinsky-Clerambault syndrome, when patients feel severe anxiety. However, subsequently the symptoms become more obvious if we talk about the perception of the patient by others.

At first, a person has pseudohallucinations and aggressive hallucinations, he is afraid of them and is constantly in a state of anxiety. But later they become friendly, and the patient feels elated. He begins to say that he has superpowers and can influence people and the world, for example, read the thoughts of others.

Unusual processes begin in memory. In particular, a person suddenly remembers an important event, which, in fact, either did not happen at all, or is slightly different from the form in which they appear to him now.

The further development of pathology is accompanied by the formation of fantastic and absurd delusions. The patient may feel like a messiah, believe that the world is divided into two hostile camps - his supporters and opponents. The following symptoms are also observed:

False recognitions. Complete strangers seem important, as if they are taking a serious part in the patient's life.
A feeling of euphoria, elation, a desire to move and do great things “to save the world.”
Confabulation is the process of filling the memory with false memories that the patient cannot distinguish from true ones.

When conducting functional studies, it is discovered that a gross disruption of metabolic processes begins in the brain, as well as excessive activity of neurons in the subcortex.

Paraphrenia may be a stage of paranoid schizophrenia or a symptom of another disorder, such as bipolar or schizoaffective. In all cases, it takes two forms - acute, when symptoms develop rapidly and are well controlled, and chronic, which can occur continuously for decades.

Varieties and symptoms

Several types of disease progression have been described in the scientific literature. The first is episodic, in which a period of exacerbation of symptoms alternates with a state of remission. There is complete or incomplete remission. In the first case, the patient experiences an episode of complete relief of symptoms. In the second case, the manifestations of the disease do not go away completely. The second type of flow is continuous. In this case, the disease progresses progressively, there are no periods of remission. All types of illness involve an altered state of thinking and perception. The integral structure of consciousness is disrupted and disintegrates.

Researchers consider productive symptoms to be the central feature of the paranoid form. The main role is given to illusions and delusional thinking. The behavior of patients is often withdrawn; aggression and rudeness are possible. Characterized by frequent mood swings. Joy and depression alternate at intervals of several minutes.

The pathology code in ICD 10 is F20.0. Basic symptoms of the paranoid form of schizophrenia:

delusions of influence or persecution, special purpose, jealousy or relationship, etc.;
auditory, visual, tactile hallucinatory phenomena of a threatening form;
visual hallucinations are less common;
depersonalization;
attacks of senestopathy;
affective disorders;
violation of the emotional-volitional sphere of the personality: lack of volitional efforts, unemotionality, detachment;
disturbances in the thought process.

There are different variants of paranoid schizophrenia, different clinical pictures and symptoms. Paranoid schizophrenia tends to occur in several stages. The first is the initial period of initial symptoms of the disease. The second is the paranoid stage, which most often does not include hallucinations and mental automatisms.

The third stage is the paranoid stage, which includes delusions of an unsystematized nature, hallucinations, and Kandinsky-Clerambault syndrome. The fourth is the paraphrenic stage, accompanied by delusions of a fantastic nature. The fifth stage is the increase in schizophrenic defects. The described sequence is not typical for all patients. Sometimes the paranoid stage goes directly into the paraphrenic stage.

At the first initial stage, psychopathic-like disorders are noticeable. The symptoms can easily be confused with a personality disorder. A person suffers from depersonalization, obsessions, and hypochondria. Senestopathies occur - uncomfortable sensations without objective pathological causes, located outside or inside the body. A person acquires new character traits that were previously absent.

More often there is distrust of others, loss of interest in previously interesting activities. Emotionality dulls. The first stage lasts from 5 to 20 years. After it, paranoid syndrome is formed.

Researcher K. Conrad also points to the existence of successive stages of paranoid schizophrenia:

trema stage - a person loses the relationship between the perception of the internal and external world, characterized by a feeling of loss of freedom, depersonalization (an unrecognizable world);
apophenia stage - the relationship is lost so much that objectively existing objects and events are indistinguishable by the patient from fictitious ones, delusions and paranoid manifestations arise;
stage of the apocalypse - mental activity is destroyed, it becomes fragmented, problems with self-awareness arise;
stage of residual defects.

Paranoid syndrome

Paranoid syndrome is considered a mild form of delusion. The first symptoms are systematized delusions of an interpretative nature. Often - delirium of persecution, greatness, invention. Patients are often characterized by delusional beliefs about their spouse’s betrayal, severe hypochondria, and a belief in a non-existent illness. Patients demonstrate the following delusions:

reformism - a person is convinced that he is able to change the structure of a certain country or the whole world;
erotic - the belief in the presence of a certain stalker/sexual maniac;
conviction of high origin, the presence of non-existent ancestors - kings, princes, etc.;
Querulism - excessive struggle for one's own rights, constant filing of complaints to various authorities.

Delusional ideas are systematized - they have a logical system, subjective evidence, and arguments. Paranoid syndrome is not accompanied by perception disorders, hallucinations, or mental automatism. A clear sign of the development of pathology is problems with recognizing and perceiving humor. Some authors (G.I. Zaltsman, R.G. Ilesheva, N.T. Izmailova) indicate a high risk of developing depressive symptoms with paranoid syndrome in patients with schizophrenia.

Kandinsky-Clerambault syndrome

Kandinsky-Clerambault syndrome is named after the Russian psychiatrist V. H. Kandinsky and the French doctor G. G. De Clerambault. The disorder occurs at the third stage of development of schizophrenia. Initially, patients experience one or more types of automatisms.

With ideational automatisms, a person is convinced that other people’s thoughts are being “put” into his head. Patients describe feeling as if their thought processes could be “heard” or “read” by strangers. Sometimes the phenomenon of “theft” of the thought process occurs. Characteristic are interruptions of thoughts and the phenomenon of mentism. “Madeness” is also characteristic of the patient’s dreams and memory.

Ideatorial automatism is sometimes called associative. It affects the course of the thought process and other types of mental activity. Patients have a feeling of “sounding” of their thoughts, a feeling of memories unwinding. The second phenomenon involves the belief that extraneous forces are forcing one to remember some event in a person’s life.

Sensory or senestopathic automatisms are accompanied by fanciful, unusual bodily sensations. The patient becomes convinced that his sensations are “made” or “caused” by someone outside. This also applies to sensations of cold, warmth, excitement, etc.

Motor or kinesthetic automatisms are the belief that any activity is caused by influences from the external or unreal world. Patients claim that they move, walk or jump in ways that are inconsistent with their own will. A special place is given to speech motor pseudohallucinations. Patients indicate that the movements of their mouth or tongue are not of their own free will.

People with the described syndrome feel influence from the outside world, carried out by witchcraft, alien forces, hypnosis, radiation, etc. Mental automatisms are characterized by a certain order. At the initial stage, ideational symptoms are observed, then senestopathic, and finally kinesthetic. However, the described sequence of stages does not always occur.

The structure of Kandinsky-Clerambault syndrome contains the phenomenon of pseudohallucinations. They are visual, auditory, olfactory, gustatory, tactile, visceral, kinesthetic. Patients distinguish hallucinatory phenomena from existing objects. However, there is a feeling of “done”. Visual and auditory pseudohallucinations include:

visions of familiar or unfamiliar faces;
panoramas, landscapes;
noise (usually similar to the noise of a radio);
fragments of words or phrases.

The faces or phrases represented in the hallucinations belong to men, women, and children. In visions, both familiar and unfamiliar pictures and voices appear.

Paraphrenic syndrome

Symptoms of paraphrenia often develop at the previous stage of Kandinsky-Clerambault syndrome. Researchers emphasize that before the onset of paraphrenia, people often experience severe anxiety and fearfulness. This stage does not overtake a person suddenly. At the beginning of paraphrenia, the nature of pseudohallucinations and mental automatisms changes. If previously they were harmful and threatening, then at this stage they are characterized by goodwill. In the first stage of paraphrenia, a person is in high spirits. He begins to claim that he has paranormal, supernatural skills and abilities. The patient has the feeling that he is able to “read” the thoughts of other people and change their mood.

Unusual processes occur in memory. A person experiences the feeling that he has just remembered a long-forgotten event. This event either did not exist at all in reality, or its details were greatly distorted and supplemented. Some forces or people from the outside world allegedly “force” the event to be remembered. The described phenomenon is called memory hallucinations.

At the next stage of paraphrenia, delusions of a fantastic, absurd nature are formed. A person claims that he has become or has always been a special or popular person. There is a belief that there are special missions, the ability to influence the fate of another person or group of people. The patient says that in the country (or on the planet) there is a battle between his supporters and opponents. Fantastic delirium is always similar to the described logic of thinking of a person with schizophrenia.

Other signs of paraphrenia:

false recognitions—unfamiliar faces are perceived as important people involved in the patient’s life;
ideas of greatness;
feeling of euphoria, pleasure;
confabulation - the memory is filled with false memories.

With paraphrenia, a gross disruption of metabolic processes in the brain occurs, and excessive activity of structures in the subcortical region is observed.

Paraphrenic syndrome is formed not only in various types of schizophrenia. It is present in persons with organic mental pathologies, with atypical bipolar affective disorder, with schizoaffective disorder. There are two types of syndrome. In acute cases, symptoms develop quickly, over a short period of time, and are amenable to therapy. In a chronic course, the symptoms are poorly controlled and sometimes last for several decades.

Paranoid schizophrenia ends with the fifth stage - schizophrenic defects. After therapy, symptoms of schizophasia are often present. Speech abilities suffer - the patient constructs phrases correctly, but the meaning of their content is partially or completely absent. The behavior of patients suffering from schizophasia appears orderly and correct. After the paranoid form of pathology, the diagnosis is often changed to F20.5 (residual schizophrenia).

Delusional and hallucinatory variants

Some researchers (L. M. Elgazina, E. D. Sokolova) note that there are two types of course of the paranoid form of schizophrenia. The first is a hallucinatory or pseudohallucinatory course. The second is crazy. Types are distinguished based on which symptoms predominate. At the initial stages of pathology development, a mixed, hallucinatory-delusional course occurs.

The hallucinatory type has the following features:

the presence of pseudohallucinations or hallucinations in the disease picture;
relatively small number of delusional ideas;
mental automatisms are either absent or not clearly expressed.

During the course of delusions, pseudohallucinations and hallucinations are almost not observed. With this option, patients more often exhibit delusional thinking, ideas of persecution and influence. They also have a more pronounced syndrome of mental automatisms.

Delusional and hallucinatory variants occur in acute or chronic form. Acute course - symptoms are more pronounced, delusional ideas are not systematized, all types of mental automatisms are present. In the acute form, the patient experiences fear, anxiety, and confusion.

Chronic course - affects are less vivid, there are no feelings of confusion, delirium is systematized. In the chronic form, mental automatisms develop in accordance with the stages described above. The delusional form of the course becomes more complicated after several years of illness. Pathological beliefs develop into conspiracy theories. Fictional and real-life forces, organizations, and political parties are involved in delusional thinking.

With a hallucinatory course, auditory and verbal hallucinations are more often observed. They are often associated with the course of the thought process. The danger lies in the fact that a person in a state of delirium or pseudohallucinations is capable of harming himself and other people.

Schizophrenic defects

With schizophrenic defects, persistent personality destruction is observed. As a rule, this can be noticed during the period of remission, when the main symptoms recede. In such cases, doctors can assess how much the personality core has been affected by the pathology.

We talk about schizophrenic defects when any 4 of the following symptoms are observed:

Emotional coldness.
Decreased physical activity.
Complete lack of motivation.
Constant silence.
Unexpressive facial expressions.
Indifferent attitude towards one's appearance.

Often there are symptoms of schizophasia, in which a person speaks quite clearly, but the speech does not carry any semantic load. The words the patient uses are random. The condition is similar to delusional, but at this stage classic delirium may be absent. At the last stage, the diagnosis may be changed from paranoid schizophrenia to residual schizophrenia (ICD 10 code - F20.5).

Forecasts

Regardless of the type of schizophrenia, it is classified as an incurable mental pathology. The prognosis of the disease is particularly influenced by the timeliness of the start of treatment, its intensity and combination with social rehabilitation measures.

According to research by practicing psychotherapists, patients who sought help in a timely manner and followed all the instructions and recommendations of doctors experienced stable remission followed by complete social rehabilitation.

Do not despair if you or one of your family and friends has been diagnosed with paranoid schizophrenia. In modern psychiatry, innovative methods are used to treat mental pathologies. Timely, competent diagnosis, unquestioning compliance with all the requirements of the attending physician, support from loved ones provide a chance to minimize the negative consequences of the disease and normalize the quality of life.

Symptoms in women

There are no significant differences between the signs of paranoid schizophrenia in women and men. However, for the former, family, health and appearance always come first, so delusional ideas are associated with this. Concern with such problems also determines the nature of hallucinations.

Women are afraid that the child will be harmed, that she is aging quickly, etc. According to her, there are ill-wishers all around. Sometimes they name specific names and surnames of real people, for example, neighbors, work colleagues or relatives.

Delusional and hallucinatory course

A number of researchers, including L.M. Elgazin and E.D. Sokolov, identifies two variants of the course of paranoid schizophrenia - hallucinatory (or pseudohallucinatory) and delusional. The first is characterized by hallucinations, but a small number of delusional ideas and the absence of automatisms. In the second case, on the contrary, delirium and automatisms are disturbing.

In this case, acute and chronic development of the pathology is possible, when symptoms develop rapidly and slowly, respectively. The acute form is characterized by anxiety, fear, confusion, unsystematized delirium and all types of automatisms.

The chronic, or continuously ongoing, type of disease is accompanied by less severe symptoms. This complicates diagnosis, since outwardly a person may not differ in any way from healthy people for a long time. Only after a few years do delusional ideas become more complex. They include more and more characters, both real and fictional.

In the hallucinatory form, primarily auditory and verbal hallucinations are observed. When they appear, the patient becomes dangerous, mainly for himself, but sometimes also for others.

External signs

There are several signs by which relatives of a sick person may suspect he has schizophrenia:

He is isolated from society, sees friends less often, becomes increasingly withdrawn and does not share his experiences with family members.
A person abandons his studies, stops showing up at the university or at work.
Gradually, he begins to take less care of himself, does not shave, rarely washes and does not monitor the condition of his clothes.
The patient is obsessed with various kinds of ideas, is interested in mystical and religious teachings, studies paranormal topics, etc.
The person begins to hear worse, constantly asks again or does not respond to questions.

The difficulty is that the patient does not consider himself sick, so persuading him to undergo examination is not easy. This can often be done when the symptoms become more severe.

Diagnostics

Schizophrenia itself is easier to identify than its individual variety. It is necessary to conduct not one, but many examinations. The patient should almost always be under the supervision of specialists and relatives. Treatment does not stop even during periods of remission. In fact, it is completely impossible to cure schizophrenia, as well as to find out its true causes.

Direct diagnosis is carried out using the following methods:

Neurotesting is a set of techniques and tests aimed at studying mental processes.
Neurophysiological tests, for example, recording movements of the eyeballs to certain stimuli.
Pathopsychological examination - consultations with a psychiatrist, psychotherapist and psychologist.

You will also have to undergo all types of tests, study the anamnesis of relatives for mental disorders, and consult with other specialists in the presence of certain somatic pathologies.

It will take time for differential diagnosis, since it is important to distinguish the paranoid form of schizophrenia from its other varieties. The decisive symptoms in order to differentiate the diagnosis are delusions, voices, delusional and unrealistic beliefs.

Most likely, the patient will have to be admitted to the clinic. In some cases, it is necessary to hospitalize a patient urgently when he poses a threat to others and himself.

Treatment

Treatment of paranoid schizophrenia is a complex process that does not stop even during remissions. After relief of all symptoms, the diagnosis remains. It is not a fact that they will ever appear, but a person remains at risk forever.

Depending on the stage of the pathology, the following types of therapy may be prescribed:

Medication - the use of psychotropic substances, antipsychotics and antidepressants. In severe cases, insulin comatose treatment is prescribed.
Psychotherapy - regular sessions with a psychotherapist, not only for the patient, but also for his relatives, who will have to learn how to interact correctly with a schizophrenic.
Electroconvulsive. It is used in exceptional cases when the patient is resistant to medications or has contraindications to them. The therapy is based on exposing a person to electric current until convulsions occur. It is believed that seizures trigger certain neurochemical processes in the brain and enable short-term memory.

During the period of remission, maintenance therapy is carried out, which includes taking medications, abstaining from alcohol and periodic conversations with a psychologist. This helps prevent an attack and improve the patient’s quality of life. Sometimes it is possible to relieve him of all symptoms forever or for many years.

In general, it is important to start treatment as early as possible for schizophrenia. Then the prognosis will be relatively favorable. There is also the following pattern - the younger the age the first signs of pathology appear, the more destructive its impact on the psyche and personality.

Paranoid schizophrenia being treated in a clinic

At the Moscow center of psychiatry and psychotherapy “Preobrazhenie Clinic” you will receive everything you need for complete treatment of paranoid schizophrenia. The clinic’s specialists provide comprehensive treatment using the most effective methods. Both patients and loved ones receive assistance. You can find out the cost of services here.

Why should paranoid schizophrenia be treated?

The specialists of our clinic are attentive to each patient and are ready to help you in the fight against mental illness. Here you will receive all the necessary medical and psychological assistance, the patient will be prescribed medication and supportive psychotherapy. “Transfiguration Clinic” works so that you and your loved ones can return to a full life and forget about mental illness.

With us you will receive:

rapid treatment with accurate diagnosis;
attentiveness and understanding;
psychological support for the patient’s loved ones;
a full range of services for the rehabilitation of a patient with schizophrenia;
anonymity of treatment and compliance with confidentiality conditions.

Specialists at the Transfiguration Clinic of psychiatry and psychotherapy in Moscow are ready to help your loved one and you at any time.