Pseudoneurotic (neurosis-like) schizophrenia: causes and symptoms

Schizophrenia is often confused with other disorders and syndromes. This is due to the similarity of symptoms in different mental pathologies, as well as the large number of forms and varieties of diseases of the schizophrenia spectrum. Most of them are difficult to treat and proceed aggressively. However, there are also less dangerous species. One of them is neurosis-like schizophrenia. Let's take a closer look at its features.

Peculiarities

Neurosis-like schizophrenia is also called pseudoneurotic and schizoneurosis. The term was coined by scientists Paul Hoch and Philip Polatin in the 1940s. The name is due to the similarity of this pathology with neurotic disorders. For a long time this diagnosis was not made. As a rule, a disease with similar symptoms was considered as a type of sluggish or poorly progressive schizophrenia.

According to the International Classification of Diseases, 10th revision, neurosis-like schizophrenia is a subtype of schizotypal disorder and is included in category F21.3. The main symptoms are obsessions, compulsions, phobias and hypochondria. Therefore, it is often confused with OCD and other neurotic conditions. The onset of illnesses is similar. The following criteria help determine the diagnosis:

Neurosis occurs after a strong emotional shock, and schizophrenia manifests itself for no apparent reason.

Neurotics understand that they are sick, and therefore want to get rid of the symptoms that prevent them from living fully. Schizophrenics deny that they have the disease. As a rule, they are brought to the clinic by relatives.
Neurosis does not cause personality disintegration. After healing, a person becomes the same as he always was. Schizophrenia leaves an indelible mark, although not always serious, on the personal qualities of an individual and affects his “I”.
Neurosis can be cured completely. Schizoneurosis responds well to treatment, but the diagnosis remains for life. The risk of relapse is quite high.

The main difference between the pseudoneurotic form of schizophrenia and its other types is the ease of its course. Its symptoms are not as intense as, for example, with paranoid disorder. This means that a person with a similar diagnosis, with a favorable outcome (the probability of which is quite high), can lead a decent lifestyle.

Causes

The question of the causes of any form of schizophrenia remains open, although this disease has been studied for centuries. Scientists have made great progress in researching the brain, but today it is only 4-5% studied. When we talk about schizophrenia, regardless of its type, we mean not the causes, but the risk factors. Among them:

Genetics. If parents, grandmothers, aunts, uncles or other relatives had mental disorders, then the likelihood of their development in their descendants increases.

Spontaneous genome mutations of unknown etiology, which manifest themselves both during intrauterine development and after birth.
Disruption of brain neurotransmitters, including serotonin, which connects neurons.
Adverse social and psychological factors, including trauma, violence, oppressive upbringing, etc.

Neurosis-like schizophrenia often manifests itself at a young age - up to 35 years. The earlier its first signs appeared, the more difficult the treatment and the more dangerous the complications.

Is it possible to cure schizophrenia?

Although the stereotypical opinion that schizophrenia is a completely incurable disease has seriously strengthened in the public consciousness, specialists from the Russian clinic RehabFamily answered the question “is it possible to cure schizophrenia?” give a positive answer. Naturally, it cannot be said that this disease can be cured completely. In this matter, there is a serious difference between categories such as “treatable” and “curable.”

Curing schizophrenia is not possible without understanding the causes of its occurrence. But at the same time as searching for them, specialists must constantly work to improve treatment methods and mechanisms. Perhaps the most serious and primary problem facing the patient’s relatives and friends will be the search for a highly qualified specialist. These are the experienced personnel who work at the Russian Rehab Family clinic.

Symptoms

Symptoms of neurosis-like schizophrenia occur spontaneously, so it is difficult to associate the manifestation of the disease with any specific situation. The clinical picture may be ambiguous. In general, there are several groups of signs that are associated with the behavior, psycho-emotional background, sensorimotor and thinking of the patient. Behavioral symptoms include:

Obsessive thoughts of high strength - obsessions that force you to perform certain actions or rituals - compulsions: patients wash their hands for a long time and often, count to 10, before opening the door, turn off all electrical appliances from the outlet, double-check whether the entrance lock is closed, etc.

Alienation, withdrawal from society, narrowing of social circles. The patient makes contact more out of necessity, for example for work, than out of desire. This sign is especially striking when a person is normally sociable.
Changes in speech style, use of strange phrases, overly abstract metaphors, understandable only to the patient himself.
Wearing unusual clothes. A person suddenly changes his style, starts wearing bright, catchy and provocative things.
Ignoring conventions. Patients with schizophrenia do not follow the rules of etiquette, and the opinions of others, including comments, become unimportant for them.
Refusal to eat, which often leads to severe weight loss and even anorexia. Also, such patients often adhere to strange diets, which have not been observed before.
Asthenia. The patient quickly becomes exhausted, tired after a little work and takes a long time to recover.

Psychoemotional and neurotic manifestations of neurosis-like schizophrenia include:

mood swings for no apparent reason;
anxiety, especially among large numbers of people;
tendency to reflection and “soul-searching”;
inadequacy of emotions;
phobias of strange content (fear of the letter “o”);
Hypochondria is an obsessive fear of getting sick.

Sometimes obsessions, compulsions and phobias become so strong that the patient can no longer tolerate them. He begins to have thoughts of death and suicide.

In a state of exacerbation, anhedonia develops - the inability to experience pleasure.

Signs related to sensorimotor perception:

Derealization is a disturbance of perception in which the world around us seems unreal, separate, and devoid of color. Sometimes it is perceived as shadows or objects in fog.
Depersonalization is a disorder of self-perception, alienation from the mental properties of one’s own personality. Characterized by a feeling of having no thoughts, feelings, emotions, or character traits in the head. Some patients feel that they have lost weight, lost their voice, or become shorter.
Body dysmorphomania is the belief that one has physical defects (small genitals, large nose, etc.). In reality, there may be no defects, but this does not bother patients. They are convinced that they are ugly.

To hide his “shortcomings,” a person wears wide clothes, covers his face with a hood, puts on makeup, or signs up for plastic surgery. Anorexia or bulimia may develop against the background of disgust for one's body.

Another group of signs of a neurosis-like form of schizophrenia is related to thinking. The following disorders are observed:

poor concentration;
memory impairment;
decreased cognitive abilities;
inability to adequately evaluate one's behavior.

In general, all of the listed symptoms, including obsessions, phobias, hypochondria and compulsions, affect thinking, which becomes pathological. The patient is unable to understand the depth of the problem he is faced with.

Types of schizophrenia

Manifestations of schizophrenia are varied. There are several types of this disease.

Schizophrenia is accompanied by a disorder of thinking and perception. The course of the disease can vary significantly among different patients. Depending on the predominant symptoms, different types of schizophrenia are distinguished

Paranoid type - patients with this type suffer from hallucinations and delusional ideas. They may be aggressive, experience anxiety and attacks of anger, anxiety, and alienation;

Disorganized type – Patients with this type suffer from inappropriate emotions and are characterized by disorganization and unintelligible speech. The behavior of such people is completely disoriented, which interferes with their everyday activities, for example, dressing, cooking or taking a bath;

Catatonic type - patients with this type suffer from dysfunction of the musculoskeletal system. They can spend hours in one position, not speak during the day, or do not stop moving for a minute;

Undifferentiated type - this type includes the symptoms of all the previous ones, although they may not appear quite clearly;

Residual type - may occur sporadically.

Examples

With schizophrenia, and in almost any of its forms, a person looks strange. Many people notice these oddities and communicate with the patient less and less. The latter perceive themselves as healthy, and are able to justify any changes in behavior.

If we talk about phobias, they are very unusual. A person is afraid of getting sick, becoming infected, dying, or getting into a dangerous situation. To avoid this, he performs rituals that he believes should prevent danger.

Some patients wash their hands 3 times before leaving the house, rubbing their skin until it bleeds, others cannot sit on a chair until they walk around it three times or until someone close to them touches its leg. Sometimes the patient needs to turn around the left shoulder several times before performing this or that action.

Over time, there are more and more rituals. A person cannot make a decision and is afraid of everything.

Obsessions are associated with fruitless philosophizing. The patient talks about the universe, about man’s place in the universe, about his own great destiny, etc. When he is criticized, he withdraws into himself. It seems to him that he is saying something smart and brilliant, but from the outside it all sounds like nonsense.

Often the patient's reasoning is contradictory and primitive. If he does not speak them, but writes them down in his diary, then it is almost impossible to read them. Even if you manage to make out the letters, you still won’t be able to find meaning in what is written.

Sometimes obsessions cause both horror and pleasure in a person. So, one teenager constantly wanted to think about how a car ran over him and rolled his insides onto the asphalt. From these thoughts he felt great fear, but at the same time he enjoyed it.

Schizoneurosis in women almost always manifests itself in changes in appearance. The patient begins to wear makeup a lot, and provocatively, wears ridiculous clothes and uses pretentious accessories. So, she can wear shorts with a fur coat, including in hot weather. She will not pay attention to comments from the outside.

Teenagers who develop neurosis-like schizophrenia are usually dissatisfied with their appearance, or more precisely, with their body. Boys feel that their penis is too small and irregular in shape. Girls suffer from “excess weight”. Some patients develop aversion to their face or a particular part of it, such as the nose. Such sensations force patients to close themselves off, hide their bodies, etc.

Dissatisfaction with one's appearance can be a consequence of complexes or real reasons - obesity, scars, birth defects, etc. However, with neurosis-like schizophrenia, even plastic surgery does not help get rid of self-loathing.

The subject of anxiety can be not only “flaws” in the body, but also odors. Thus, some patients believe that they have an unpleasant odor - from their mouth, feet, hair or skin. Indoors, such patients always sit by the windows, cover their mouths with their hands and turn to the side when talking.

The idea of your own ugliness may come to your mind suddenly. Let’s say a child heard from adults or read information about hermaphrodites on the Internet. After this, he begins to think that he is growing female breasts.

Hallucinations in schizoneurosis usually do not occur - only with the progression of the pathology and lack of treatment.

There are times when a patient has a real defect, but he does not notice it. In other words, his actions, actions and thoughts are contradictory, and his emotions are inadequate to the situation. All this catches the eye of others. They make comments to him, but the person believes that everyone around him is wrong, and he alone is normal.

Diagnosis and treatment

During the initial diagnosis, the doctor examines the patient and talks with him. After this, relatives can be interviewed. The psychiatrist must see the picture from different sides, and not just from the words of the patient, who may be inadequate during an exacerbation. It is also necessary to find out whether a person has a genetic predisposition to such disorders. To do this, it is determined whether there were schizophrenics and mentally ill people in the family.

Diagnostics includes standard laboratory and instrumental procedures, including MRI, CT, EEG, tests, etc. Various psychotherapeutic tests are also prescribed. To make an accurate diagnosis, you need to differentiate it from similar disorders. This may require more than one month of observation of the patient.

Treatment is based on psycho- and drug therapy. The patient comes to individual and group sessions with a psychiatrist and also takes antipsychotic medications. The dosage and type of medicine are determined by the patient's condition. Atypical antipsychotics are usually prescribed. Relatives of the patient also come for consultation with a psychotherapist, who will have to learn how to interact with a schizophrenic.

Psychotherapy for schizophrenia

The positive impact of psychotherapy in the treatment of schizophrenia is very difficult to overestimate. Modern treatment methods are distinguished by a humane approach to each patient. The specialists of the RehabFamily clinic have extensive experience in this area. Psychotherapy for schizophrenia has evolved greatly in our time. If in the first stages only individual forms of treatment were carried out, then later it became group therapy and even family therapy, because it played a big role in helping a patient with schizophrenia return to normal life.