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Patients with schizophrenia are not aggressive. The disease tends to cause patients to isolate themselves, become withdrawn and avoid personal contact. Only under certain circumstances can patients sometimes become aggressive, particularly if they are not receiving any treatment. In such a situation, it is very important to ask for medical assistance as treatment is effective.
An initial psychotic episode is a clinical symptom that could occur in several types of disease, it is not necessarily due to schizophrenia; various psychiatric illnesses, e.g., bipolar disorder, and other organic diseases may produce a very similar clinical picture.
Patients should address the disease as soon as possible so they may receive appropriate treatment and to minimise the period of disease progression. Other positive influences on the prognosis are: as relaxed an environment as possible and no substance abuse.
Schizophrenia has a wide variety of symptoms; it typically manifests because the individual experiences delusions and hallucinations, although they are not always present. The patient often displays a sudden change in their behaviour. In addition, there are usually signs of affective, depressive or other symptoms, behavioural disorganisation and an inability to adapt to the surroundings.
Schizophrenia tends to have a chronic progression. This does not necessarily mean the long-term prognosis will be negative. There are a lot of illnesses which, even though they are chronic, do not interfere with the patient’s ability to adapt or affect their quality of life.
Remember that schizophrenia follows a rule, the three thirds rule which states that one third of patients will progress favourably, one third will remain stable and the other third will progress unfavourably.
Relapses cannot always be avoided. They sometimes occur spontaneously, and are unrelated to factors external to the actual disease. Schizophrenia is a disease which tends to recur, but the likelihood of a relapse is much higher in patients who abuse substances or abandon the treatment early.
The risks associated with schizophrenia are related to the actual disease, the most common ones being suicide and a deterioration in physical health. Patients with schizophrenia pay less attention to their overall care, while the medical team and their family tend to be more concerned with their mental health rather than their physical health. This, along with substance abuse, means they have a much higher risk of developing a wide variety of pathologies.
Medication must be taken continuously as part of schizophrenia treatment.
Patients who have experienced just a single episode may be advised to follow the treatment for only a limited period of time; but whenever an individual has had more than one episode, then they will need to continue taking the medication for prolonged periods or even indefinitely.
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Substantiated information by:
Miguel Bernardo ArroyoPsychiatristPsychiatry and Psychology Department
Miquel Bioque AlcázarPsychiatristPsychiatry and Psychology Department
Published: 20 February 2018
Updated: 30 November 2022
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