How to recognize signs of schizophrenia in a person. How to recognize and identify schizophrenia in yourself: diagnosis of schizophrenia. How does schizophrenia begin?
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It must be remembered that these signs of mental disorders can occur in incomplete form in other mental pathologies. Or, on the contrary, in some forms of schizophrenia, there are no deceptions of perception and delusional symptoms, and only apatho-abulic syndrome is expressed - weakness of will and impoverishment of emotions. Therefore, only a psychiatrist can make a correct diagnosis during a face-to-face appointment. And in the case of schizophrenia, long-term observation is required in a psychiatric hospital. How does schizophrenia manifest? At the beginning, middle and end of its development, schizophrenia manifests itself in different ways. Depending on the form, the disease can begin in different ways. Paranoid and catatonic schizophrenia can manifest as a manifestation of acute psychotic disorder at a fairly young age. The simple form has a gradual course and often a complete absence of delusional symptoms and hallucinations. If there are delusional ideas, by the middle of the illness the delirium is systematized - the picture links the images with a certain logic that is understandable to the patient. By the end of the disease, when there is practically no criticism of the condition and there are signs of personality degradation, the delusion becomes broken, i.e. unsystematized. The complexity of delusional content is simplified, hallucinations lose their brightness and direction. Lack of interest in the external world leads to impoverishment of the internal world. The progression of any type of schizophrenia sooner or later leads to the destruction of personality, aimless existence and loss of interest, both in the world around us and in oneself. The earlier drug treatment is started, the greater the likelihood of maintaining individuality and the desire for social activity. Safe Center "Preobrazhenie Clinic" offers outpatient and inpatient treatment in Moscow. If necessary, you can call a psychiatrist to your home; patients can attend socio-psychological rehabilitation groups and learn to understand themselves and the external space. How to identify schizophrenia in humans and animals Schizophrenia and other endogenous mental illnesses are completely absent in animals. If neurosis occurs in domestic pets after experiencing severe stress or prolonged discomfort, then wild animals do not even have neurotic disorders. What does this mean? That animals are not prone to unproductive mental and physical activities. All animal behavior is constructive and aimed either at gaining experience or at ensuring its livelihood. Moreover, the presence of intelligence and complex emotions has been proven in higher animals. They do not have improper upbringing, insoluble conflicts or eternal sadness about what was lost. All questions are resolved and brought to their logical conclusion. Lonely non-adaptive animals either die or get used to a solitary existence. Sorrows are forgotten, wounds heal, bones grow together - and the beast is activated again to life. Schizophrenia definition Schizophrenia is a serious pathology of the behavioral-cognitive sphere associated with profound disturbances in relationships with oneself and the world. The change of generations transmits a certain style of behavior from generation to generation, fixing it at the genetic level. In schizophrenia, thinking, attention, the area of emotions and intentions are irreversibly changed. But it is possible to smooth out the changes and learn to manage your mental health with long-term and in-depth psychotherapy. Does schizophrenia occur in animals? No. And this gives us an understanding that there are no structural changes in the brain with this disease, but there is a distorted perception of oneself and others. This speaks for the possibility of a cure for schizophrenia. But the life of one person is not always enough to cure a birth disease. But with each new effort the condition will stabilize and the disease will recede. How to identify schizophrenia Schizophrenia affects almost all areas of human mental activity. Diplomas from the Russian Foundation for the Protection of Consumer Rights - “Best Clinic in Russia”The person gradually withdraws into himself, losing social contacts.
How to identify a schizophrenic? The manifestation of schizophrenia can be recognized by the following parameters:
- An apathetic attitude towards oneself and the outside world is manifested in sloppiness and a strange style of clothing, and a lack of self-care. Patients are often unshaven with dirty hair. Loss of interest in work, disappearance of previous interests, no strength or desire to gain new experience and learn.
- A person with schizophrenia stops communicating with people. Becomes colder with friends and relatives, he does not trust people. In his delusional reasoning, he ceases to need an interlocutor.
- Thinking becomes fragmented and speech incoherent; Although the phrases have a formal correct construction of words, the very essence of the story is missing; Neologisms are invented - new words that are completely devoid of meaning.
- Emotions are either contradictory and inadequate to the situation, or flattened. In patients with schizophrenia, during an exacerbation, states of freezing in unusual positions are possible. Mental and motor restlessness. Often moments of aggression are replaced by periods of good nature and submission. Anxiety due to the inability to control conditions leads to sleep disturbances and general restlessness. Depression in schizophrenia has no cause and is usually not noticeable in appearance.
- Changes in behavior are manifested by unusual hobbies, eccentricity and pretentiousness, asociality with early alcoholism, running away from school, and theft. Patients experiencing hallucinations listen to something, hide, and become suspicious.
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It must be remembered that these signs of mental disorders can occur in incomplete form in other mental pathologies. Or, on the contrary, in some forms of schizophrenia, there are no deceptions of perception and delusional symptoms, and only apatho-abulic syndrome is expressed - weakness of will and impoverishment of emotions. Therefore, only a psychiatrist can make a correct diagnosis during a face-to-face appointment. And in the case of schizophrenia, long-term observation is required in a psychiatric hospital. How does schizophrenia manifest? At the beginning, middle and end of its development, schizophrenia manifests itself in different ways. Depending on the form, the disease can begin in different ways. Paranoid and catatonic schizophrenia can manifest as a manifestation of acute psychotic disorder at a fairly young age. The simple form has a gradual course and often a complete absence of delusional symptoms and hallucinations. If there are delusional ideas, by the middle of the illness the delirium is systematized - the picture links the images with a certain logic that is understandable to the patient. By the end of the disease, when there is practically no criticism of the condition and there are signs of personality degradation, the delusion becomes broken, i.e. unsystematized. The complexity of delusional content is simplified, hallucinations lose their brightness and direction. Lack of interest in the external world leads to impoverishment of the internal world. The progression of any type of schizophrenia sooner or later leads to the destruction of personality, aimless existence and loss of interest, both in the world around us and in oneself. The earlier drug treatment is started, the greater the likelihood of maintaining individuality and the desire for social activity. Safe Center "Preobrazhenie Clinic" offers outpatient and inpatient treatment in Moscow. If necessary, you can call a psychiatrist to your home; patients can attend socio-psychological rehabilitation groups and learn to understand themselves and the external space. How to identify schizophrenia in humans and animals Schizophrenia and other endogenous mental illnesses are completely absent in animals. If neurosis occurs in domestic pets after experiencing severe stress or prolonged discomfort, then wild animals do not even have neurotic disorders. What does this mean? That animals are not prone to unproductive mental and physical activities. All animal behavior is constructive and aimed either at gaining experience or at ensuring its livelihood. Moreover, the presence of intelligence and complex emotions has been proven in higher animals. They do not have improper upbringing, insoluble conflicts or eternal sadness about what was lost. All questions are resolved and brought to their logical conclusion. Lonely non-adaptive animals either die or get used to a solitary existence. Sorrows are forgotten, wounds heal, bones grow together - and the beast is activated again to life. Schizophrenia definition Schizophrenia is a serious pathology of the behavioral-cognitive sphere associated with profound disturbances in relationships with oneself and the world. The change of generations transmits a certain style of behavior from generation to generation, fixing it at the genetic level. In schizophrenia, thinking, attention, the area of emotions and intentions are irreversibly changed. But it is possible to smooth out the changes and learn to manage your mental health with long-term and in-depth psychotherapy. Does schizophrenia occur in animals? No. And this gives us an understanding that there are no structural changes in the brain with this disease, but there is a distorted perception of oneself and others. This speaks for the possibility of a cure for schizophrenia. But the life of one person is not always enough to cure a birth disease. But with each new effort the condition will stabilize and the disease will recede. How to identify schizophrenia Schizophrenia affects almost all areas of human mental activity. Diplomas from the Russian Foundation for the Protection of Consumer Rights - “Best Clinic in Russia”The person gradually withdraws into himself, losing social contacts.
How to identify a schizophrenic? The manifestation of schizophrenia can be recognized by the following parameters:
- An apathetic attitude towards oneself and the outside world is manifested in sloppiness and a strange style of clothing, and a lack of self-care. Patients are often unshaven with dirty hair. Loss of interest in work, disappearance of previous interests, no strength or desire to gain new experience and learn.
- A person with schizophrenia stops communicating with people. Becomes colder with friends and relatives, he does not trust people. In his delusional reasoning, he ceases to need an interlocutor.
- Thinking becomes fragmented and speech incoherent; Although the phrases have a formal correct construction of words, the very essence of the story is missing; Neologisms are invented - new words that are completely devoid of meaning.
- Emotions are either contradictory and inadequate to the situation, or flattened. In patients with schizophrenia, during an exacerbation, states of freezing in unusual positions are possible. Mental and motor restlessness. Often moments of aggression are replaced by periods of good nature and submission. Anxiety due to the inability to control conditions leads to sleep disturbances and general restlessness. Depression in schizophrenia has no cause and is usually not noticeable in appearance.
- Changes in behavior are manifested by unusual hobbies, eccentricity and pretentiousness, asociality with early alcoholism, running away from school, and theft. Patients experiencing hallucinations listen to something, hide, and become suspicious.
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Schizophrenia. This concept from the field of medicine can be heard quite often in everyday life. What do people mean when they call a person schizophrenic?
Most often you can hear the answer that a schizophrenic is a person with abnormal behavior, from the point of view of others. But this does not mean that he is suffering from schizophrenia.
An abnormal, non-standard style of behavior that is not characteristic of a particular person is not an indicator of schizophrenia. The reason for this behavior may be deep personal experiences, severe stress, chronic fatigue, and the consequences of experienced trauma.
Therefore, a clear understanding of the symptoms of schizophrenia can help distinguish this disease from other diseases.
What is schizophrenia
The main difference between schizophrenia and other mental illnesses is that the cause of its occurrence is associated with internal changes occurring in the body. That is, external factors in no way can become a prerequisite for the development of this disease, which cannot be said about other mental disorders. In particular, signs such as delirium and sudden changes in mood can be the result of a traumatic brain injury, manifestations of hysteria - a consequence of severe emotional shock, etc.
Psychiatrists consider schizophrenia to be a chronic disease in which a person’s perception of the outside world is disrupted, as well as a disorder of thinking with completely satisfactory intellectual functioning.
Moreover, the degree of mental development in a patient with schizophrenia can be either low or quite high - at the level of genius.
The uniqueness of this disease lies in the fact that the organs of perception, intellect, and memory function correctly. The problem arises when the brain, having perceived information from the outside, transmits it to the consciousness for processing. It is at this stage that distortion of the information received occurs. That is, there is a breakdown in consciousness, which is unable to create a correct objective picture of the external world. This is evidenced by the very name of the disease: schizophrenia - “disorder of consciousness.”
Primary signs
A characteristic sign of schizophrenia, in most cases, is the gradual increasing progress of the disease with the manifestation of two or three symptoms at an early stage, which over time can worsen and be added by other signs.
The initial stage of schizophrenia can be recognized by the presence of the following symptoms:
- Loss of the ability to perform even basic household tasks due to a lack of understanding of the need to perform them (for example, the patient does not wash his clothes, since they will still be dirty again);
- Speech disorders (slow speech, predominantly monosyllabic answers to questions);
- Emotional rigidity (slowness of emotional reactions);
- Inability to concentrate on an object;
- Loss of interest in previously meaningful activities.
Insufficient attention to these manifestations often leads to the development of more serious symptoms of schizophrenia. In psychological science they are usually divided into 4 groups:
- Positive;
- Negative;
- Disorganized;
- Affective.
Positive symptoms
Scientists call positive symptoms that appear during the development of the disease.
By “positive” symptoms we do not mean the formation of good qualities, but the appearance of new signs that are uncharacteristic of a healthy personality.
Psychiatrists consider positive symptoms:
Hallucinations.
These are disturbances in the perception of information from the outside world. A person receives it thanks to the presence of his sense organs. Hallucinations manifest themselves at the level of sensations that do not actually exist. A person hears non-existent sounds, voices or speech that come from the outside world or “sit” in his head.
The peculiarity of the hallucinations of a patient with schizophrenia is that he actually feels them, and does not just imagine them. A schizophrenic really sees and hears aliens, smells vanilla from cutlets, etc.
Rave.
This is the presence of a set of certain beliefs that do not coincide with reality. Delusions can form autonomously during the development of schizophrenia, as well as as a result of the effects of hallucinations.
There are many types of delusions, depending on the nature of the beliefs that arise. Very often, the development of delusions of persecution is observed, when the patient thinks that someone is watching him, pursuing him, “breathing in his back.” Delusions of influence are also widespread, when a person believes that someone controls him and constantly influences his life.
Inappropriate behavior.
Illusions.
Inappropriate behavior can manifest itself in excessive excitement, a high degree of naivety and stupidity, as well as through a discrepancy between the style of behavior and appearance and the circumstances. The most severe stage of this behavior is catatonia - a person adopts absurd poses for a long time or chaotic, confused movements.
Negative symptoms
Negative symptoms are human qualities that have disappeared or are greatly dulled by a progressive disease.
Characteristic signs of negative symptoms are:
- Decreased energy;
- Manifestation of pessimism and indifference;
- Craving for loneliness;
- Decreased physical activity;
- Disorders of speech abilities and thinking;
- Inability to concentrate on a subject or moving object;
- Wave-like mood;
- Lack of self-control;
- Lethargy;
- Reduced emotional reactions;
- Mother of motivation, etc.
Diseases of the nervous system occur quite often in people with a hereditary predisposition. Most of them are treatable, after which the person returns to a full life. But, what is schizophrenia and whether it is possible to get rid of it completely or not? Unfortunately, even a qualified doctor still cannot accurately answer these questions. But the fact that this disease leads to complete loss of ability to work has been proven repeatedly.
The disease schizophrenia is one of the most dangerous diseases of the nervous system, suppressing the will of the patient, which ultimately leads to a deterioration in the quality of his life. However, in some cases, the development of pathology can be stopped, preventing disability. The types of schizophrenia and, accordingly, its forms can be different, and they differ significantly from each other, but psychiatrists argue that this disease is not one illness, but several types of illness.
Despite observations and research by specialists, the origin of the syndrome has not been fully established. Therefore, schizophrenia and its symptoms still remain a relevant topic. And among the common people, this disease is known under the name “split personality” (due to the patient’s behavior and the illogicality of his thinking). Most often, early symptoms of pathology make themselves felt at the age of 15-25 years and in the absence of adequate therapy they rapidly progress.
The main role in the occurrence of the disease is played by the hereditary factor. External causes (mental disorders, nervous system, past illnesses, head injuries, etc.) are only of secondary importance and are only an activator of the pathological process.
How does the insidious syndrome manifest itself?
Experts approach the study of schizophrenia and the final determination of this diagnosis with caution. A wide range of possible disorders is being studied: neurosis-like and mental.
Among the emotional symptoms of the disease, the main signs stand out:
- Prostration - a person experiences complete indifference in the fate of people close to him.
- There is also inappropriate behavior - in some cases there is a strong reaction to various stimuli: every little thing can cause aggression, attacks of inappropriate jealousy, anger. People who are close to us suffer as a result. The patient behaves as usual with strangers. The first signs of schizophrenia are loss of interest in everyday activities and things.
- Dulling of instinct - a person suddenly experiences a loss of appetite for food, he has no desire to lead a normal life, to take care of his appearance. All schizophrenia syndromes are also accompanied by delusion, which manifests itself in an incorrect perception of everything that is happening around.
- The patient sees strange colored dreams, he is haunted by obsessive thoughts that someone is constantly watching him and wants to deal with him in sophisticated ways. The patient tries to convict his other half of cheating (at the same time, his behavior with schizophrenia is obsessive in nature).
- Hallucinations - often such a disorder makes itself felt in the form of hearing impairment: the patient hears extraneous voices that suggest various ideas to him. The patient may also experience visual color hallucinations that resemble a dream.
- Disruption of normal thinking. A disease such as schizophrenia, the main symptoms and signs of which are often quite difficult to identify, is accompanied by deviations in the thought process. One of the most serious violations is disorganization in the perception of various information, in which a person completely lacks logic. Speech loses coherence, and sometimes it is impossible to understand what the patient is saying.
Another sign is a delay in the thought process (the person cannot finish his story). If you ask the patient why he suddenly stopped, he will not be able to answer this question.
- Motor dysfunctions. The causes of schizophrenia may be different, but regardless of its origin, the patient often exhibits involuntary, awkward and scattered movements, strange manners, and various grimaces. The patient may systematically repeat certain actions or fall into prostration - a state of unresponsiveness, complete immobility.
If there is no treatment for schizophrenia, then catatonic syndrome is the first symptom observed in a person. Thanks to modern therapeutic techniques, this phenomenon is quite rare.
If the first signs of schizophrenia are almost impossible to detect at the initial stage of pathology, then hallucinations and delusions cannot be overlooked.
In families in which there are constantly attacks of unjustified jealousy and scandals, aggression, depression, many attribute them to mental disorders, and only in the last place do relatives begin to think that this is schizophrenia, the main symptoms and signs of which are not yet so pronounced. But with healthy relationships, the disease is easy to identify in the initial stages of its development.
Main forms of the syndrome
Experts identify the main types of schizophrenia and, accordingly, its forms.
Name | Characteristic symptoms |
Paranoid pathology | How to recognize a schizophrenic in this case? The disease is accompanied by unrealistic ideas combined with auditory hallucinations. Pathologies in the emotional and volitional areas are milder than in other types of illness. |
Hebephrenic type of syndrome | The disease begins at a young age. Therefore, it is important to understand what schizophrenia is and how to recognize it in order to prevent further development of the pathological process. With this type of illness, numerous mental disorders are noted: hallucinations, as well as delusions, the patient’s behavior can be unpredictable. Diagnosis of schizophrenia in this case is carried out quite quickly. |
Catatonic type of pathology | Psychomotor disturbances are quite pronounced, with constant fluctuations from an excited state to complete apathy. Whether schizophrenia is curable in this case or not, doctors find it difficult to answer. With this type of disease, negative behavior and submission to certain circumstances are often encountered. Catatonia may be accompanied by vivid visual hallucinations and clouding of adequate consciousness. Experts are still wondering how to remove the diagnosis of schizophrenia in the presence of similar symptoms. |
Residual syndrome | The chronic stage of the pathological process, in which negative symptoms are often present: decreased activity, psychomotor retardation, passivity, lack of emotions, poor speech, the person loses initiative. How such schizophrenia is treated and whether it is possible to eliminate negative factors for a certain period of time, only a specialist can answer after a thorough examination of the patient. |
Simple illness | Another type of pathology, with a hidden but rapid development of the process: strange behavior, lack of ability to lead a socially adequate standard of living, decreased physical activity. There are no episodes of acute psychosis. A disease such as schizophrenia is dangerous; how to treat it can only be determined after examination. |
Schizophrenic psychosis and “split personality” are two types of pathology, the course of which is sometimes similar. Clinical signs most likely act as additional symptoms of the syndrome that may not appear. In psychosis, hallucinations and delusions predominate. Schizophrenia is treatable (its progression can be stopped), but for this it is necessary to recognize it in a timely manner.
Alcohol syndrome: signs
This pathology does not exist as such, but systematic drinking can trigger the development of the disease. The state in which a person finds himself after a prolonged “binge” is called psychosis and is a mental illness and does not apply to schizophrenia. But due to inappropriate behavior, people call this disease alcoholic schizophrenia.
Psychosis after prolonged consumption of alcohol can occur in several ways:
- Delirium tremens - appears after giving up alcohol and is characterized by the fact that a person begins to see various animals, devils, living beings, and strange objects. Besides this, he does not understand what is wrong with him and where he is. In this case, schizophrenia is curable - you just need to stop abusing alcohol.
- Hallucinosis – appears during prolonged alcohol consumption. The patient is bothered by visions of an accusing or threatening nature. Is schizophrenia treatable or not? Yes, in this case you can get rid of it after proper therapy.
- Delusional syndrome – observed with systematic, prolonged consumption of alcohol. Characterized by poisoning attempts, stalking and jealousy.
A disease such as schizophrenia is dangerous and the causes of its occurrence in this case play a special role, since after giving up alcohol and appropriate treatment, you can get rid of the pathology forever.
How to determine the presence of “split personality”?
Schizophrenia and its diagnosis play a special role in the patient’s life. Therefore, it is necessary to establish the presence of the disease in a timely manner. According to established rules, the examination is carried out according to certain criteria and in sufficient detail. First, primary information is collected, including a medical interview, complaints, and the nature of the disease.
What kind of disease this is and the main reasons for the rapid development of schizophrenia can be found out using the main diagnostic methods:
- Special psychological testing. This technique is informative in the initial stages of the disease.
- MRI of the brain - this procedure reveals the presence of certain disorders in the patient (encephalitis, hemorrhages, malignant neoplasms) that can affect a person’s behavior. Since the symptoms of the disease, regardless of the type of disease, are somewhat similar to the signs of organic brain disorders.
- Electroencephalography – identifies injuries and pathologies of the brain.
- Laboratory research: biochemistry, urine analysis, hormonal status, and immunogram.
To determine an accurate diagnosis, additional examination methods are used: arterial examination, sleep study, virological diagnosis. It is possible to finally identify the manifestation of “split personality” and prescribe adequate treatment for schizophrenia only if a person has signs of the syndrome for six months. Must establish at least one obvious, as well as several vague symptoms:
- a violation of the normal thought process, in which the patient believes that his thoughts do not belong to him;
- feeling of influence from the outside: the belief that all actions are carried out under the direction of an outsider;
- inadequate perception of behavior or speech;
- hallucinations: olfactory, auditory, visual, and tactile;
- obsessive thoughts (for example, excessive jealousy);
- confusion, disruption of motor functions: restlessness or stupor.
With a comprehensive examination of the pathology, every tenth patient is given an incorrect diagnosis, since the causes of schizophrenia, as well as its manifestations, can be different, so it is not always possible to identify a dangerous illness in a timely manner.
How to provide adequate therapy
Most psychiatrists suggest that treatment of schizophrenia, that is, the stage of its exacerbation, is best carried out in a hospital, especially with the first mental disorder. Of course, the hospital must be well equipped and use only modern diagnostic and therapeutic methods. Only in this case can you get a more accurate picture of the disease, as well as select appropriate treatment methods for schizophrenia.
But we should not forget that being in a hospital is stressful for the patient, because it completely limits his freedom of action. Therefore, hospitalization must be fully justified, the decision must be made taking into account all factors and after exploring other alternatives.
Duration of adequate therapy
Regardless of the type of schizophrenia, treatment of the disease should be constant and long enough. Often, after the first attack, therapy with psychotropic medications and antipsychotics is prescribed for several years, and after a repeated episode - at least five.
About 70% of patients stop taking the medicine because they feel completely healthy, not realizing that they have just entered the remission stage. Another category of patients suffering from schizophrenia refuses maintenance medications due to lack of effectiveness of therapy, as well as weight gain and drowsiness.
How to prevent possible relapses?
The main goal of therapy is treatment of the disease aimed at preventing attacks. For these purposes, doctors use long-acting medications: Rispolept-Konsta, the drug Fluanxol-Depot, and only in some cases due to the negative effect on the symptoms of the Klopixol-Depot syndrome.
Maintenance therapy should be long-term and carried out under constant medical supervision, taking into account the rate of development of biochemical, hormonal, and neurophysiological indicators, and include psychotherapy with the patient. It is necessary to teach the patient’s relatives the tactics of their behavior, which will prevent relapse of the disease.
Are people with multiple personality disorder aggressive?
Patients diagnosed with schizophrenia are practically not prone to psychosis or violence, and most often prefer peace. According to statistics, if a patient has never crossed the bounds of the law, then even after his illness manifests itself, he will not commit a crime. If someone diagnosed with multiple personality disorder behaves aggressively, their actions are often directed at people close to them and manifest themselves within the confines of the home.
Treatment of “multiple personality disorder” is a rather difficult task, both for the public and for doctors. Therefore, the question of whether schizophrenia can be cured remains relevant to this day. Timely therapy and medications preserve the patient’s quality of his usual lifestyle, ability to work and social level, thereby allowing him to provide for himself and help his loved ones.
Internet marketer, editor of the site "In an accessible language"
Publication date: 10/16/2017
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One of the most pressing issues in psychological counseling, and even more so when conducting psycho- and hypnotherapy, is the identification of schizophrenic patients in the early stages of treatment. It is clear that in the course of work, a psychologist cannot and should not work with patients with schizophrenic pathology; psychiatrists specialize in this.
If he takes on this case, he endangers not only his client's health, but also his own. A patient with an open delusional plot, with hallucinosis, with some other conspicuous manifestations of schizophrenia, which are written about in literature, mainly fiction, is quite easy to identify. But in fact, schizophrenia is diagnosed not by such obvious, striking symptoms, but by completely different ones. And identifying precisely the hidden, simple form of schizophrenia at the initial appointment, especially the neurosis-like form, which is often very similar to neurosis, is the primary task of the psychologist.
It should be noted that the criteria given in this article can act as a support in diagnosing a disease only when they are used together, but not separately. In addition, the psychologist should carefully study the symptoms and make sure that the patient has psychotic symptoms and not neurotic ones.
So, what are the criteria for diagnosing schizophrenia?
Firstly, it is ambivalence and ambitendence, that is, the ability to simultaneously experience opposite emotions in relation to one object (person or phenomenon).
Secondly, this is a disorder of associative activity, thinking, isolation of the patient, fear of people. Also apathy and abulia. Abulia and apathy are most easily translated into non-medical language as a kind of universal laziness: the patient finds it difficult to do basic things, and to find an excuse for his inactivity, he sometimes comes up with excuses that are quite funny, in the eyes of a healthy person. For example: “I’m not going to work today because it’s raining” - this is a classic example of the thinking of such a patient. At the same time, it is important for a psychologist to be able to distinguish such “laziness” from similar symptoms of neurotic depression or.
Now let's move on to practice, how to apply this knowledge at the initial appointment. Since the patient’s thinking is upset and he thinks illogically, a very important sign is his lack of punctuality, or rather his attitude towards being late or arriving early.
The first sign: endogenous patients usually arrive for appointments at the wrong time, often either late or delayed; usually enter through the back door rather than the front door of the hospital. In addition, they do not seem to notice their absent-mindedness, for example, if a person who is simply not punctual is late from session to session, but at the same time will wildly apologize, look for excuses for himself, or simply be embarrassed, then a schizophrenic does not do this, he simply does not notice his absent-mindedness .
The second point to pay attention to is that a schizophrenic may not make eye contact at all. This is otherwise called ocular autism, when the patient does not look the doctor in the eye, and this is one of the signs of schizophrenia. It is absolutely clear that hiding your eyes when telling something shameful or something you want to hide is a normal human reaction. But if during the entire session the patient avoids the specialist’s gaze, then this is already a reason for a deeper diagnosis, in which it is important to make sure that the symptom is not the result of a deep feeling of guilt or shame.
The third point is the patient’s clothing, or rather, its illogicality: mixing styles, wearing old, shabby clothes when the person has the opportunity to purchase normal, new ones. That is, some minor inconsistencies that cannot be explained by direct logic.
The next thing to pay attention to is how the patient moves. Patients with schizophrenia have some cataleptic movements - they freeze, take (uncomfortable) positions in a chair that a healthy person never takes. But the main oddity is that patients, being in an often uncomfortable position, do not reflect either anxiety, or a state of comfort, or demonstrativeness with their posture.
Fourth: inconsistency of speech. To detect this sign in a patient, sufficient training and the skill to pay attention to some non-logical or paralogical or near-logical constructions in speech are required. This is defined as follows: sometimes the patient is asked a fairly simple, specific question, and the patient answers either around the question or not to it, or first answers the question and then goes into philosophizing that does not relate to the topic being asked, does not relate to the patient’s current complaints . This was one of the ways to identify the illogicality of speech. This check should be carried out several times, because it happens that the patient simply does not understand the question, although the question should be formulated as precisely as possible. An example of a question: “how many grades in school have you completed?”
The next point: the discrepancy between the strength of the psychological trauma and the magnitude of the complaint. Often such patients of the neurotic type view their psychotrauma as the cause of their illness, despite the fact that schizophrenia is not a consequence of psychotrauma. And when we see much more psychopathic behavior in a patient than the psychotraumas he named suggest, we should continue the diagnosis in more depth and, if necessary, recommend an appointment with a psychiatrist.
The biggest mistake in diagnosing a schizophrenic happens when the one who diagnoses him begins to sympathize with him. How this can be: due to the autism and apathetic symptoms of the patient, he often loses his job, but for the loss of each job he has some explanations, for example: conflicts with his superiors, the work has become uninteresting, he no longer feels inspired, and so on etc. It is important here to correlate the reality of the story with what the patient is telling.
As an example: a person who graduated from college, having a good academic record, cannot find a job for a number of years and is supported by his parents, already arouses certain suspicions.
The emotional sphere of the patient also requires special attention. Apathy, in other words, the inability to experience emotions, is present only in the later stages of the development of the schizophrenic process. In the early stages, rudeness and emotional incongruity arise; the patient seems to talk about himself as if a bad actor were portraying the patient. That is, we do not see small emotions, just as we do not see those little things, those antics, that emotional play that an ordinary patient or client has.
Perhaps these were all the factors that we wanted to tell you about. Once again, as a reminder, I would like to emphasize: none of the above signs individually is considered an indicator of schizophrenia; they can only be such in combination.
If you suspect this diagnosis in a patient, then in order to make sure that you are not dealing with deep or shallow neurosis, or depression, which is disguised as apathetic-abulsic symptoms, it is advisable to have the skills of basic psychodiagnostics.
The most clear tests for diagnosing schizophrenic disorders and diseases are: exclusion test, classification test. Pictograms in Khersonsky’s modification and the Luscher color test in Sobchik’s modification have a supporting role.