Residual schizophrenia may be the mildest of all of the documented subtypes of this mental illness. According to DSM-IV-TR, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the five subtypes of this disorder are paranoid, catatonic, undifferentiated, residual, and disorganized. The residual subtype diagnosis simply means that an individual presents symptoms at a low intensity after at least one acute episode of another subtype of schizophrenia in the patient’s history. This previous episode could be diagnosed as any one of the other subtypes.
While the patient will have a prior history of at least one psychotic episode with positive symptoms of one of the other subtypes, these episodes will have now diminished from the acute phase of this disorder. Symptoms are usually passive at this point rather than active and at the height of their acuity.
This diagnosis can be a good and beneficial sign because it indicates a transition from an acute episode to remission. Conversely, this state might continue for years or simply be a break between more acute episodes. The eventual outcome may depend upon how this transitional phase is managed. Even though the disease’s symptoms may seem much milder during this residual phase, proper management is just as important as it is during more severe episodes. Inattention to treatment may result in another episode of the more severe forms of schizophrenia.
Residual Schizophrenia Diagnosis
How do psychiatrists diagnose the residual schizophrenia subtype? The following symptoms will be considered by the patient’s doctor. Keep in mind that these symptoms must follow at least one episode that was diagnosed as a more severe subtype of this disease.
- Passive symptoms: These might include poor self-care skills, underactivity, a lack of initiative, or poor verbal and non-verbal communication.
- Lack of positive symptoms: These individuals do not suffer from acute positive symptoms of the other subtypes though they have in the past. These positive symptoms include hallucinations, delusions, catatonic behavior, and disorganized behavior and speech.
- Absence of other disorders: In other words, there is no diagnosed organic brain disease, depression, or other illness that might explain the symptoms.
Many patients will experience periods of more or less intense symptoms over the course of years. They may move back and forth between the residual subtype and another subtype. Others will remain in this transitional state for a long period of time. Some patients make progress towards partial or complete remission and recovery.
Report any changes in behavior and symptoms to the individual’s doctor or therapist. Changes in care, therapy, and medication may be needed. This is true if symptoms become more or less severe. It may be helpful for all patients, even high functioning schizophrenics, to appoint a loved one to assist them with this and make sure that this individual has access to the patient’s doctors and signed privacy forms.
Residual Schizophrenia Treatment
Psychiatrists typically prescribe anti-psychotic medication for this illness. This type of medication helps the patient manage their symptoms, and it may also reduce the likelihood of another full-blown psychotic episode. Depending upon the unique symptoms presented by each individual, anti-depressants or mood stabilizers may also be indicated.
Understand that prescribed medications may be the reason why a patient has moved from a more severe type of schizophrenia to the residual type. That is why it is important to manage medication under the guidance of a professional even when symptoms have diminished. Removal of appropriate medications might actually trigger a severe episode again. For example, if a particular anti-psychotic medication has helped a patient manage acute symptoms, removal of that drug might trigger one of the more severe symptoms to reemerge.
Besides prescription drugs, therapy can be a very effective tool to help sufferers manage their symptoms. It may also help a patient’s family, or other caregivers, cope with this disease. While the patient is the main focus of treatment, this disease can be tough on people around the patient as well. These are some common types of schizophrenia therapy:
- Family Therapy: The patient’s support group may benefit from participating in therapy sessions. This can help the family understand and cope with this disease. The patient’s mood may also be elevated because of active support from his or her loved ones.
- Group Therapy: The patient may engage in group therapy sessions with other patients to help build social skills and a supportive network of other sufferers. This can also alleviate a feeling of being the only one to suffer from this malady.
- Cognitive Behavior Therapy: This helps patients address negative emotions and behaviors and gain an awareness of their own cognition.
- Social Skills Training: This helps patients develop appropriate verbal and non-verbal communication. This type of therapy will differ depending upon the functioning level of the individual. Some patients may need help performing simple social tasks while others may be ready to develop skills that will help them find and maintain a job.
Schizophrenia Residual Type Prognosis
A residual schizophrenia diagnosis might be a good sign, especially after an acute episode of one of the more subtypes of this disease. Sometimes this indicates that the patient has entered a transition period which will lead to remission. However, this is not certain.
This period may also last for a long time without much change. It may also only be a temporary reprieve from the more severe symptoms of a more acute subtype of this malady. This may be particularly true if the patient or the family gets too comfortable and discontinues the very treatment that has helped reduce symptoms in the first place.
It is important to keep appointments with doctors and therapists, even if the patient appears to be much better. While some schizophrenics need help with self-care and financial support, others return to very high functioning and productive lives.
As with any type of schizophrenia, better outcomes are usually enjoyed by people who stick to their treatment plans, had more productive lives before the onset of the disease, developed symptoms later in life, and have a good support system in place. In general, the higher functioning people were before they suffered from this mental illness, the more likely they are to return to a higher functioning level.