Paranoid (paranoid) Schizophrenia - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Paranoid (paranoid) schizophrenia

Content:

• Paranoid schizophrenia symptoms
• Causes of paranoid schizophrenia
• Diagnosis of paranoid schizophrenia
• Treatment for paranoid schizophrenia
• Paranoid schizophrenia prognosis

Paranoid schizophrenia is a type of schizophrenia characterized by the prevalence of hallucinations and delusions. Other symptoms may also be present, but they are not so pronounced.

Statistics indicate that it is paranoid schizophrenia that occurs more often than others. A distinctive feature of this type of disease is that the person suffers from paranoid, paraphenic or paranoid types of delusions. At the same time, the thought processes of such people, although clouded, are not fragmented. This means that for the patient the world around him is a complete picture, and not fragmentary constructions, models and images.

There are many famous people who suffered from paranoid schizophrenia, including: football player L. Aldridge, musician and composer T. Harrell, model B. Page and others.

Paranoid schizophrenia symptoms

Among the main symptoms of the disease are:

• Auditory hallucinations. It seems to a person that thoughts are instilled in him at a distance, that pseudo-voices are discussing how he behaves, commenting on his actions. The voice can come from different parts of the body.
• Paranoid Syndrome. The patient suffers from delusional ideas, among which persecution mania prevails. He believes that someone is manipulating him. Moreover, all pathological feelings and thoughts for him are as real as for a healthy person - the ordinary world.

• The patient suffers from mood disorders. In addition to the fact that a person has obsessions, he can be sure of his own omnipotence, that he was created to rule the world, God, the solar system, etc. These thoughts are often expressed in conversations with other people. The patient claims that he is able to change the climate, make life beautiful, create heaven on earth. The patient's mood can range from elated to manic. He believes that he is always at the epicenter of grandiose events, great discoveries.
• Kandinsky-Clerambeau syndrome is often observed, when the patient believes that someone is controlling and manipulating him. He, in his opinion, is a puppet, which is led by higher powers, aliens, etc. He often speaks about this with conviction.
• Speech disorders and emotional disorders are weak. Sometimes they are completely absent, especially in the initial stages. However, as the disease progresses, emotional and volitional disorders begin to increase.
• Catatonic symptoms are observed, among which the most noticeable are: affective behavior, dumb agitation, catatonic stupor. However, these symptoms are not dominant.
• The patient may also exhibit symptoms characteristic of a flattened affect. He becomes insensitive, cold, does not show any emotions to the suffering of loved ones.

As for delusions, several of their varieties are often observed at once, for example, delusions of grandeur are combined with delusions of persecution. Often such patients are incredibly religious.

Causes of paranoid schizophrenia

Since the debate continues about why schizophrenia develops, it is still impossible to assert with 100% certainty about the reliability of any of the reasons.

However, among the most likely factors affecting the formation of paranoid schizophrenia, the following are distinguished:

• Heredity. The risk of getting sick increases to 12% if close relatives have a history of schizophrenia. However, many scientists argue that there are other factors in the formation of the disease, in addition to genetic predisposition.
• Disorders of intrauterine development as a result of exposure to infections that the mother has suffered.

• An imbalance in the chemical processes occurring in the brain, associated with disruption of the work of various receptors. If earlier scientists believed that dopamine production disorders mainly affect the development of the disease, now the role of such neuromodulators and their receptors as norepinephrine, acetylcholine, glutamate, serotonin is not denied.

Most scientists are convinced that several theories underlie the development of schizophrenia, so it is necessary to create a comprehensive model of the etiology of the disease, which would combine neurochemical and neuroanatomical theories together.

Diagnosis of paranoid schizophrenia

The general criteria for schizophrenia are applied to make a diagnosis. The doctor should establish episodes of obvious hallucinations or delusions, recorded emotional, volitional and speech disorders. Typically, hallucinations that indicate paranoid schizophrenia boil down to the fact that the patient hears a threatening or imperative voice, or hum, laughter and whistling.

Delirium is mandatory for patients:

• Greatness;
• Impacts;
• Harassment;
• Noble birth;
• Special purpose, etc.

The doctor should exclude possible drug and epileptic psychoses, since they are similar in symptoms to paranoid schizophrenia.

Treatment for paranoid schizophrenia

In order for the disease not to progress as long as possible, it is necessary to implement three directions in treatment: drug therapy, psychotherapy and rehabilitation measures.

Drug therapy

It includes taking antipsychotics, which are prescribed by a doctor. In modern psychiatry, both typical antipsychotics and atypical (new generation drugs) are used. While classic drugs are aimed at blocking dopamine receptors, newer antipsychotics regulate the work of seratonin receptors to a greater extent. As a result, it is possible to avoid many side effects, improve the patient's cognitive capabilities and have an antidepressant effect. Classical neuroleptics include Haloperidol, Aminazine, Tizercin (Levomepromazine), atypical drugs - Clozapine, Aripiprazole, Amisulpride, Olanzapine and others.

In addition, antipsychotic drugs of a new class are used - partial agonists. They are able not only to lower the level of endogenous dopamine, but to regulate it: block or activate. Among such agents are Ziprasidone, Aripiprazole.

Taking medications is not limited to hospital conditions. The patient should receive them at home, as needed. When the acute stage is eliminated, the doctor will determine the optimal maintenance dose, which will allow the prevention of possible relapses and the development of the defect.

On the subject: A complete list of drugs used for schizophrenia

Psychotherapy

It is aimed at ensuring that close people of a schizophrenic patient can fully understand and accept an unusual state of the human psyche, so that it is easier for them to cope with stress, so that they can provide him with at least minimal independent help. Psychotherapy is an important stage in the fight against the disease, but to achieve the maximum effect, close interaction in the structure: "family + patient + doctor" is required.

Patients are in dire need of empathy from the people around them, in their support. Therefore, understanding and meeting the patient's social needs contributes to his maximum adaptation and a decrease in the level and number of exacerbations. The passage of individual, family, group and other types of classes will allow not only to better understand and accept the condition of a sick person, but also to enhance the effect of drug therapy.

It is important not to try to dissuade the patient that his hallucinations are unreal, this will only alienate him, make him more withdrawn. At the same time, one cannot agree that they are real. Finding a compromise is the first thing to do. It is necessary to make it clear to the person that on this score everyone has their own point of view, and it should be respected.

Rehabilitation measures

Rehabilitation techniques are aimed at helping the patient to adapt as much as possible after suffering an exacerbation of the disease. It should start as early as possible, immediately after the patient returns from the clinic, this will provide an opportunity for early social adaptation, will allow you to quickly return to normal life. This is why family and individual counseling by a psychotherapist is so important.

Among effective trainings, there are: trainings of self-esteem, communication, independent living. Individual psychotherapeutic treatment is aimed at constant interaction between the patient and the doctor, conducting conversations on topics of concern to the patient, discussing urgent problems, joint search for solutions. Only in this way will it be possible to establish a strong connection between the patient and reality, to develop his desire to preserve it. In addition to a psychotherapist, psychologists, social workers and, of course, close people can come to help in the rehabilitation of a patient with schizophrenia.

Paranoid schizophrenia prognosis

There are certain factors that indicate a favorable prognosis for the course of the disease. In the event that the patient is female, if his family history is not burdened with this disease, if the onset of the disease was acute and not latent, then the prognosis for the course of paranoid schizophrenia is positive.

Sluggish manifestation of the disease, male sex and the presence in the family of another patient with a similar diagnosis, makes the prognosis less favorable.

In many ways, the severity of the course of the disease is influenced by timely medical care, as well as the support of loved ones and society. Studies have shown that negative attitude to the patient's personality on the part of society, critical statements, hostility, an attempt to forcefully control a person's life leads to an increase in the risk of relapse of the disease.

Author of the article: Sokov Andrey Vladimirovich | Neurologist

Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".