Treatment of schizophrenia

Treatment of schizophrenia

The term schizophrenia sounds like a severe endogenous procedural mental illness, which is accompanied by acute polymorphic psychotic episodes, as well as an increase in deficit symptoms and social and labor maladjustment during the attack-free period.

In order to understand what this complex and very multifaceted disease is, it is necessary to understand several concepts that have sounded above. Endogeneity means the presence in the psyche and nervous system of a person of some abnormal, painful (pathological) process that leads to the development and progression of the disease. This excludes a possible exogenous (external) cause (use of surfactants, toxic, infectious lesions, etc.) of the psychotic state.

Procedurality means, literally, the presence of a disease development process. In other words, schizophrenia is not an outbreak of inappropriate behavior that happens suddenly and passes without a visible trace for the human psyche. These are periodic polymorphic psychotic states that lead to an increase in deficiency symptoms and maladjustment in the attack-free period.

Deficit symptomatology, also known as a “defect,” is perhaps the worst thing about this disease. The most pronounced, colorful and stormy psychotic episodes are just episodes that, at the present stage of the development of medicine, are quite successfully stopped (although this may take some time). But each such episode or the absence of supportive treatment during the period of remission leads to an increase in apathy, lack of initiative, a decrease in volitional impulses, emotional coldness and monotony. As a result, a person loses the desire and ability to go to work, communicate with people, the circle of interests and acquaintances narrows over the years and as a result a person can become disabled (schizophrenia is one of the diseases for which a group of disabilities is established from III to I, when a person does not able to take care of himself).

The only possibility for existence will be regular help and supervision of relatives or a systematic stay in a psychiatric hospital. However, fortunately, things do not always end so badly. With timely diagnosis, the beginning of specific treatment and the continuation of another as a supporting stage of therapy, modern medicine can successfully control this disease and enable a person to return to a normal, successful lifestyle. Further you can read about the main symptoms and methods of treatment of this disease.

Main causes of schizophrenia

Psychiatrist - narcologist
Ivan Vladimirovich Brednev

Psychiatrist - narcologist

Unfortunately for modern science, the true causes of schizophrenia remain a mystery. Schizophrenia is considered a multifactorial disease, in other words, there are many known and unknown factors that can affect the onset and course of the disease (environmental pollution, psychological trauma and prolonged stressful periods, hereditary tendency, low social activity, the use of psychoactive substances, etc.).

However, it is not possible to single out one or at least several main ones among them. The mechanism of the onset of symptoms is considered to be an imbalance in the metabolism of the neurotransmitters of dopamine and, to a lesser extent, serotonin in the brain (and as a result, treatment is aimed at controlling these processes), but this is just an explanation for the onset of symptoms, and not the immediate cause of the disease.

Inherited schizophrenia – is it possible to come it by?

Modern research shows that people whose blood relatives suffered from mental illness (including schizophrenia) are statistically more likely to get sick. However, this probability is far from 100%, but much less (data from different studies differ). Moreover, it is believed that there is no “schizophrenia gene”, but a combination of various genetic factors that can increase the likelihood of the disease. As a result, it is often impossible and impractical to trace “where did it all come from”, since it does not affect the nature of the treatment in any way, and the transfer of such genes is possible up to seven generations. The main thing that is important to understand is that the diagnosis of “schizophrenia” is not a reason to give up the prospect of having children. On the other hand, this means that even with healthy parents, a child can develop schizophrenia, since the disease does not distinguish between well-being, status and success.

Medical classification (types and kinds) ​​of schizophrenia

Schizophrenia is divided into several types depending on the prevailing symptomatology, and also into several types depending on the nature of the course. However, it is worth remembering that this division is very arbitrary and often does not have a significant impact on the selection of treatment. In modern classifications of mental illnesses, it is proposed to abandon the division of schizophrenia into types altogether, since this does not matter much.

Before the general classification, it is worth highlighting such a diagnosis as “schizotypal disorder”. Previously, it had the name “sluggish schizophrenia”, but then it was abandoned. The schizotypal disorder is characterized by a mild course, a low tendency to psychotic episodes and an often positive prognosis due to a slight increase in deficiency symptoms.

Types of schizophrenia:

Paranoid – characterized by the predominance of “paranoid” or delusional symptoms, which can be accompanied by hallucinatory experiences in the form of “voices” not unknown in society, as well as anxiety, agitation, insomnia, inappropriate statements and behavior.

Catatonic – characterized by the presence of motor retardation up to stupor (a person can spend hours or days in a monotonous, seemingly fantastically uncomfortable or pretentious posture, not respond to addressed speech, refuse to eat), with a spontaneous sudden transition into an absurd, non-targeted motor excitation with possible aggressive behavior.

Hebephrenic – characterized by the predominance of ridiculous, rude, inadequate, almost childish behavior. Often accompanied by sexual disinhibition. Relatively poorly amenable to drug treatment.

Simple is perhaps the most insidious look. Characterized by the absence of psychotic episodes, the disease begins gradually and immediately with the formation of deficit symptoms. The insidiousness is that the person himself and those around him notice the signs of the disease when the process has gone quite far.

Types of treatment:

Continuous – characterized by frequent psychotic episodes with practically no periods of remission, a rapid increase in deficiency symptoms.

Episodic or recurrent – characterized by episodic psychotic states with long periods of remission and often the absence of an increase in deficiency symptoms.

Paroxysmal-programmed (fur-like (from the word fur – blow in German)) – occupies an intermediate position between the above-described types of flow.

Main symptoms and signs of schizophrenia

Often, schizophrenia has a prodromal or incubation period that can last from several weeks to several years and is not accompanied by symptoms characteristic of schizophrenia, however, some peculiarities can be noticed during this period. Further, we will consider these features in detail, however, it is worth remembering that the presence of one or even several of these signs does not yet indicate the presence of schizophrenia, but are only an excuse for a preventive purpose to consult a specialist.

The first signs of the disease may appear several weeks or years (on average 2-3 years) before the full onset of the disease. These signs include:

  • Overvalued ideas and hobbies – a person begins to pay a lot of attention to mystical, religious and philosophical reasoning, trends, up to “fanaticism”. It is also called metaphysical or philosophical intoxication.
  • A decrease in the ability to productive activity (work, study) – manifests itself in the form of a decrease in motivation for activity, a search for an ephemeral meaning in what is happening, a general decrease in activity.
  • Personality Changes – personality traits can begin to change for no apparent reason.
  • Decrease in general activity, need for communication, craving for loneliness.
  • Odd behavior.
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The presence of one or more of these signs does not mean the presence of a disease. Especially if such symptoms occur in adolescence, which is difficult in every sense of the word, which significantly complicates the diagnosis of the disease.

Directly, the symptoms of schizophrenia are divided into positive (productive) and negative (deficit). Let’s consider them in more detail.

Disorders of thinking are distinguished separately. They are characteristic of the spectrum of schizophrenic diseases and are manifested by a loss of purposefulness, the consistency of mental activity. Such violations of thinking are called formal, since they relate not to the content of thoughts, but to the thought process itself. First of all, this affects the logical connection between thoughts, in addition, the imagery of thinking disappears, a tendency towards abstraction and symbolism prevails, there are breakdowns of thoughts, a general impoverishment of thinking or its unusualness with the originality of associations, even absurd ones. In the later stages of the disease, the connection between thoughts is lost even within the same phrase. This is manifested in the discontinuity of speech, which turns into a chaotic set of scraps of phrases that are completely unrelated to each other.

In milder cases, there is a logic less transition from one thought to another (“slipping”), which the patient himself does not notice. Thinking disorders are also expressed in the emergence of new pretentious words, understandable only to the patient himself (“neologisms”), in fruitless reasoning on abstract topics, in philosophizing (“reasoning”) and in the disorder of the generalization process, which is based on inessential signs. In addition, there are violations such as an uncontrolled flow or two parallel flows of thoughts.

Marchenko
Alexander Vyacheslavovich Marchenko

Physician psychiatrist

It should be emphasized that, formally, the level of intelligence (IQ) in persons suffering from schizophrenic spectrum diseases differs only slightly from the IQ level of healthy people, i.e. intellectual functioning in this disease remains fairly intact for a long time, in contrast to specific damage to cognitive functions, such as attention, the ability to plan one’s actions, etc.

Less often, patients suffer from the ability to solve problems and problems that require the involvement of new knowledge. Patients select words according to their formal characteristics, without caring about the meaning of the phrase, they skip one question, but answer another. Some thought disorders appear only during an exacerbation (psychosis) and disappear when the condition stabilizes. Others, more persistent, remain in remission, creating the so-called cognitive deficits.

Positive (productive) circle of disorders: pathological signs or symptoms acquired in the course of the disease are, as it were, added to the state of the patient’s psyche, which was before the disease. These include:

Paranoid syndrome (paranoid) – characterized by the presence of delusional symptoms (delusional ideas). Delusional ideas are conventionally divided into several types: ideas of attitude, persecution (known in society as “persecution mania”), poisoning, special significance, influence, control. Moreover, the content of these ideas can be very individual and colorful. Someone thinks that special services are watching him, someone that distant relatives and neighbors.

The very content of these ideas does not affect the nature of the treatment. However, the content of these ideas can influence the danger of the condition for a person and others. For example, if a person believes that his food is being poisoned, then, according to his inner morbid logic, he may completely refuse to eat. At the same time, if a person believes that someone from his environment commits these actions, it may seem quite logical to sort out the relationship with the “offender”, which may end in conflicts, aggression and many inappropriate statements to the police. A person does not always express such experiences out loud, but the presence of such ideas can be assumed by delusional behavior. A sharp refusal to eat, communicate with certain close people, search for listening equipment at home, search for imaginary pursuers (constant peeping out of windows, peephole of the door), protective actions (curtain windows, barricading doors). Delusions can also be hypochondriacal in nature (inadequate interpretation of sensations in the body, confidence in the presence of serious and rare diseases and a combination of these).

One of the main characteristics of delusional ideas is the impossibility of a rational or logical way to convince a person of the inadequacy of experiences. Moreover, such attempts can be accompanied by sharp irritability, conflict, aggressive reactions.

Hallucinatory syndrome (hallucinosis) – the presence of pseudo-hallucinations in a person (unlike true hallucinations, a person hears or feels hallucinations in his body and especially his head). They are often represented by single or multiple voices of familiar and unfamiliar people in the head. Hallucinations can be intermittent or persistent. The intensity or strength of hallucinations can also differ from barely audible and practically not affecting the patient’s condition to deafening in which a person can fall into a hallucinatory stupor and not respond to external stimuli.

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    The content of these “voices”, as in the case of delusional ideas, can be very individual, but in general they are divided into several types. Commentators – as the name implies, comment on the actions and thoughts of a person, can be both positive (joke, praise) and sharply negative (scold, humiliate).

    Advisers – offer a person to perform certain actions, productive or unproductive.

    Imperative – unlike the previous type of voice, they order certain actions to be performed, while resisting them is extremely difficult, sometimes impossible. Imperative hallucinations can be both neutral in nature and cause a person to harm others and himself, to commit suicidal actions.

    Hallucinatory symptoms are not always manifested by “voices,” often in the form of sensations in the body, the feeling that the body or psyche of a person is controlled by outside forces.

    Human interpretation of hallucinatory experiences can also be very diverse: some believe that sensations are the result of exposure to electromagnetic rays, the influence of special services equipment, the influence of God or the Devil. Also, the patient may be accompanied by a feeling of “openness” of his thoughts to others, as well as a belief in the ability to hear and influence the thoughts of people around him.

    As in the case of delusional ideas, a person does not always express his feelings out loud, but their presence can be assumed by unusual behavior. The patient can laugh out of nowhere, talk to himself or address an imaginary interlocutor, listen to something, look around, close his ears and turn on music loudly to shut himself out of these experiences.

    The negative (deficit) circle includes the “loss” of powerful layers of the psyche caused by a painful process, which is expressed in a change in the character and personal properties due to a weakening of the integrative activity of the central nervous system. At the same time, patients become lethargic, have little initiative, passive (“decreased energy tone”), their desires, impulses, aspirations disappear, emotional deficit grows, they become fenced off from others, avoidance of any kind of social contacts. Responsiveness, sincerity, delicacy is replaced in these cases by irritability, rudeness, quarrelsomeness, aggressiveness. In addition, in more severe cases, patients develop the above-mentioned disorders of thinking, which becomes unfocused, amorphous, and meaningless. Patients can lose their previous work skills so much that they have to register a disability group.

    Men and women’s differences in the symptoms of schizophrenia

    There are no significant differences in the manifestation of schizophrenia symptoms in men and women. Men are more prone to aggressive tendencies and actions, women are prone to demonstrative behavior, however, given the high individuality in the manifestations of the disease, these features are extremely relative. It is believed that schizophrenia in women progresses more favorably, but this is not significant compared to timely diagnosis and provision of qualified medical care.

    Stages of schizophrenia

    psychotherapist
    Irina Viktorovna Kruchkovskaia

    Psychiatrist of the highest category, psychotherapist

    There is a prodromal (incubation stage) (from several weeks to 2-3 years) when there are no obvious symptoms, but the behavioral features described above are noted. Often ends with the onset of psychosis or the so-called “debut” of the disease when the delusional and hallucinatory symptoms described above first appear.

    Stage of “exacerbation” or psychotic state. It can begin both suddenly and violently within a few days, or within a few weeks or months with a gradual increase in symptoms. Sleep disturbance is often the first alarm bell, although it is nonspecific. A psychotic state (psychosis) can last from several days to several months, depending on the individual characteristics of the person, the severity of the disease and the presence or absence of medical care. The psychotic state can be reduced (pass) even without medical intervention (spontaneous biological remission), but it often turns into chronic psychosis, which is difficult to treat and has a very negative effect on the prognosis. At this stage, methods of active treatment are used.

    Remission is a stage in which there are no or minimal symptoms of schizophrenia. With the implementation of the recommendations of specialists and the availability of supportive treatment, it is quite possible for a person to return to their usual way of life, social and work activity. The quality and duration of remission depends directly on the treatment of the exacerbation (psychotic state) and the supportive stage of treatment. Supportive treatment is not prescribed for several months in advance, but should be controlled depending on the patient’s condition. In this case, two factors are important:

    1. Treatment must be sufficient to keep the person healthy;
    2. Treatment should not interfere with the person’s normal life and create undue discomfort.

    Episodes of schizophrenia

    An attack of schizophrenia (“exacerbation”) is a psychotic state (psychosis), which is accompanied by the appearance or intensification (if in a state of remission, it is not possible to achieve a complete reduction of symptoms) positive (productive) symptoms. The first psychotic episode in a person’s life is also called the onset of the disease.

    The manifestations of psychosis are highly individual, both between patients and within the same process. Psychosis can occur both abruptly, literally within a few days, or increase gradually, over several weeks and months. It is very important for the patient to monitor his own state, since often when others notice inadequacy in behavior, painful symptoms have already been present for some time. The earlier a person asks for help with symptoms of deterioration, the faster and more efficiently they manage to cope with the situation. Often, one of the first alarming signs of a worsening condition is a deterioration in sleep, an increase in isolation, anxiety. Subsequently, delusional and hallucinatory symptoms join this. The greater the severity of the symptomatology, the less a person is able to control his behavior and the more likely he will cross the conditional “line”, after which he will lose the last connection with reality and plunge headlong into a maelstrom of painful experiences.

    Due to the distortion of perception and thought processes, a person can perform a wide variety of inappropriate, including aggressive actions, because according to his inner, painful logic (paralogics), these actions are completely rational. Sometimes patients under the influence of the disease can commit crimes, harm property, themselves and others. A common mistake of close people in such situations is to try to convince the patient of his painful experiences. As mentioned above, one of the characteristics of a delusional idea is the inability to rationally or logically convince a person. Attempts to demonstrate the falsity of experiences also end in fiasco.

    For example, a patient claims that bandits are hiding behind the front door who want to kill him. When demonstrating that there is no one behind the door, the person begins to assert that the pursuers simply hid around the corner. When no one is found around the corner, it turns out that they are already on the roof or waiting outside the entrance door, etc. The laxity of the patient’s experiences can cause irritation, anger, conflict. In contrast to this, it is also impossible to “get involved” in painful experiences, confirm them, encourage them, and take an active part. Given the unpredictability and illogicality of inferences, relatives trying to help in this way can be involved in a delusional structure and, as a result, the patient can commit verbal and physical aggressive actions towards them (demand and knock out a confession in a conspiracy, treason, etc.).

    What to do in this situation? Try to behave as neutral as possible, try to calm down, persuade to see a specialist. Unfortunately, it is far from always necessary to be included in delusional symptoms to become a part of it. One of the most difficult psychological circumstances for close people is that they become the most terrible enemies for the patient. In this situation, the main thing to remember is that this negative, sometimes evil and aggressive attitude does not come from the patient’s personality, but is a painful symptomatology (although psychological trauma cannot be completely avoided anyway).

    The psychotic state presupposes active, often inpatient treatment. Very often it is associated with a partial or complete absence of the patient’s criticism of his condition, which complicates the appeal to a specialist and even more hospitalization. “I’m healthy. You need – you are treated!”.

    Treatment of schizophrenia in Kyiv

    Thanks to the development of medicine, significant progress has been made in the treatment of schizophrenia and mental disorders in general. The first drug and the first antipsychotic for treatment appeared in the 50s of the twentieth century, it was chlorpromazine or Aminazine, known in our area. This drug for the first time made it possible for psychiatry not only to restrict the patient’s freedom in anticipation of a spontaneous improvement in the condition, but also to directly influence the course of the disease. This drug is morally and literally outdated, however, it still occupies its niche not only in the treatment of mental disorders, but also in other emergency conditions. Another, perhaps much better known, drug is Haloperidol. There are many horror stories and myths about this drug (not all of them are unfounded), but it is still one of the most effective drugs for the treatment of acute psychotic conditions.

    Pharmaceuticals have made great strides since then. A huge number of neuroleptics of the most diverse in their properties and characteristics have been synthesized. All of them occupy a certain niche or, in other words, are keys to open the lock of a mental disorder.

    As a result of the high individuality of people, not only in the personal and characterological, but also in the biochemical sense, the task of the psychiatrist is to select “the very key”. Complicating the task is the fact that antipsychotics have a range of specific side effects. At the same time, side effects are not allergic reactions and in order to predict the occurrence of side effects, it is impossible to make a skin allergy test (such as with antibiotics).

    These side effects include neuroleptic or extrapyramidal syndrome, akathisia, parkinsonism. They manifest themselves in painful muscle spasms up to the impossibility of making habitual movements, tremors, anxiety, restlessness, restless physical sensations in the body and especially in the legs.

    The incidence of these side effects is relatively low and modern drugs are significantly less likely to cause them.
    Fortunately, these side effects do not have any long-term consequences, but suggest discontinuation of the drug and specific drug therapy. As a result, in the case of acute symptoms, and especially at the first meeting of a person with such medications, it is highly desirable that the treatment takes place in a hospital setting. Since when the patient is under the constant supervision of specialists, it is possible to eliminate side effects as soon as possible and choose an alternative treatment for a person. In this regard, in a hospital setting, drugs with a short duration of action are often used.

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    Hospital treatment consumes several important components

    First component: sedation. It involves the use of drugs of a sedative nature, since psychotic disorders can be accompanied by severe anxiety, agitation, and insomnia. As a result of their actions, a person can calm down, finally sleep, behavioral disorders are less pronounced. This component is very important and plays a leading role in the early stages. The close people of the patient can very often be frightened by this stage, since it is associated with severe drowsiness, lethargy, passivity. However, you cannot do without this, and it is important to remember that this is temporary and will pass with the abolition of drugs without harm to the psyche and the body as a whole. Sometimes the opposite attitude is met: “it is enough for him / her to sleep it off to make everything go away. This is not true, after waking up, the symptoms will play with renewed vigor. To prevent this from happening, the next component is important.

    Second component: dealing with productive symptoms. For this, antipsychotics of incisive action are used. They provide relatively little sedation. Their task is to correct the biochemical imbalance that is the cause of delusions, hallucinations, and emotional inadequacy. This effect is not instantaneous; the neuroleptic takes several days to fully take effect. There are often cases when, after the first dose, a person’s condition improves significantly, however, it is no less rare when the necessary result has to wait for several days or even weeks. This component is associated with the greatest likelihood of side effects and should be carried out under the strict supervision of a specialist. Drugs that are actively used in the hospital do not always move to the stage of supportive treatment, very often a much softer and more comfortable medication is selected for a person.

    Third component: restorative therapy and monitoring of vital signs. Mental illness drains a huge amount of mental and physical strength from the body. A person is exhausted, cannot sleep normally and recuperate, his appetite decreases. Therefore, it is necessary to make up for the lack of vitamins, nutrients, fluids.

    Fourth component: recruiting related specialists. Being in a painful state, a person tends to ignore the cries for help from his body. Often there is an exacerbation of chronic somatic diseases, the acquisition of new ones, including injuries. Fortunately, in the vast majority of cases, we are not talking about serious complications or life-threatening situations. However, in the presence of problems and indications, the psychiatrist engages other specialists to provide the patient with full assistance.

    The final stage of inpatient treatment is the selection of supportive therapy, which will contribute to the complete recovery of a person from a painful state, maintain it normal and prevent possible exacerbations. Unlike many other areas of health in psychiatry, with the exception of certain diseases, it is impossible to “go to the hospital for a dip” once or twice a year for the purpose of prevention. Supportive therapy is a process that must be continuous, otherwise it can lead to a significant deterioration in the condition. The nature of maintenance therapy can be roughly divided into two options: taking medications in tablet form and taking depot drugs.

    Depot drugs are prolonged-action drugs, produced in the form of ready-made solutions or suspensions for the preparation of the drug on the spot. It is administered by intramuscular injection. Such drugs work from several weeks to a month and allow many patients to abandon the daily pill intake. The dosage is adjusted by the frequency of the injections. Before prescribing such medications, a specialist must make sure as much as possible that a person will tolerate them well (all these drugs are also available in a “short” form), since if side effects occur, it is physically impossible to abruptly cancel the drug, it is necessary to wait for it to leave the body.

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    It is also worth mentioning one of the most common myths and fears of both patients and their close people. Can treatment of a person make him a “vegetable”? The question sounds so often that sometimes there is a desire to take courses in vegetable growing in order to be more competent in this matter. Nevertheless, the question is very serious and its roots are growing since the days of Soviet psychiatry. Punitive psychiatry meant the placement in compulsory treatment of people who did not have any pronounced mental disorders, but were, due to their public position or outlook, disliked by the authorities. Naturally, when using antipsychotics without indications, it does not lead to any positive result, but makes a person depressed, passive. On the positive side, antipsychotics do not leave long-lasting effects and give their effect (positive or negative) only during their use. Therefore, many dissidents and cultural figures, after their compulsory “treatment”, could return to ordinary life and creativity, while feeling the Damocles sword of repeating the situation for the rest of their lives.

    The second reason for this myth is drug sedation. Indeed, a person under sedation is passive, drowsy, physically weak, little contact. However, as described above, this is necessary, especially in the early stages and sedation takes place along with the withdrawal of drugs. A psychiatrist, like any doctor, is not interested in harming the patient and his ultimate goal is to return the person to a normal life. In a sense, it can be compared with an operation – it is extremely problematic to carry out without anesthesia.

    The last reason is sadder and tragic. Schizophrenia is not terrible because of a psychotic state; it is quite possible to cope with it with modern methods of pharmacotherapy. Schizophrenia is terrible with the deficit, negative symptoms described above. With the uncontrolled course and progression of the disease, a person becomes more and more withdrawn, motivation, impulses to action falls, the emotional background flattens, even facial expressions and movements become sluggish and monotonous. The patient loses the opportunity to show empathy, social and work activity and, as a result, becomes disabled. In other words, it turns into that very “vegetable”. As a result, not knowing the specifics of such diseases, the layman notices a simple causal relationship: a person goes to the hospital and leaves there as a “vegetable”, which means that the treatment made him a “vegetable”. This does not take into account that a person was hospitalized because he fell ill and it is not known how long he was ill before starting treatment. The longer a person is sick, the more likely it is that with the disappearance of psychosis, scars will remain on the psyche, which is very difficult to cope with. Not to mention the fact that with an extremely unfavorable course of the disease, elements of the defect can appear after the first psychotic episode (fortunately, this does not happen often).

    The process of schizophrenia can be compared to a ladder: each psychosis is a step down for the psyche as a whole. It is not without reason that schizophrenia is sometimes called cancer of the soul, which means that the treatment is chemotherapy. Before the advent of antipsychotics, the outcome of the disease was often very tragic – a person died from exhaustion, hunger and thirst. At some point, the mental defect became so deep that the patient could die of hunger while lying on the bed, while not even paying attention to the tray of food standing next to him. This is what it means to become a “vegetable” and this process is final.

    If a person needs inpatient treatment in Kyiv, the choice is not great. Ordinary somatic hospitals do not undertake to treat a person with a mental illness (and rightly so, there are no corresponding conditions there). If we talk about state institutions, then this is the notorious hospital named after. Pavlova (now called differently) or the first regional psychiatric hospital in the village. Glevakha near Kyiv. The specialists work there are good, and most of the private psychiatrists have graduated from there. However, the conditions of stay often leave much to be desired, drug provision in recent months has also suffered greatly (in contrast to the situation a year ago, most of the medicines had to be bought by patients’ relatives due to changes in funding), not to mention the fact that this is a connection with a complex and cumbersome bureaucratic machine of the state.

    Fortunately, private options have emerged in recent years. The field of private psychiatric care is still very young, but it is already showing successes and results. This does not mean that private psychiatry has never existed before. Demand creates supply. However, often it was help in artisanal conditions, for example, rehabilitation centers for addicts with appropriate results (however, not always). At the moment, the license and accreditation for the provision of complex and inpatient psychiatric care is the “MEDLUX” addiction clinic, where you can receive the whole range of services from inpatient treatment to outpatient support in the future.

    Take schizophrenia test

    There are no objective tests, analyzes and instrumental studies to determine schizophrenia. Too great variety of symptoms and too much individuality of the course. Moreover, after the first and even the second psychotic episode, such a diagnosis is not made even in public hospitals. Because, as described above, schizophrenia is a process. And for the diagnosis, both positive and negative symptoms are needed.

    A considerable number of people endure psychosis in their lives and it does not always end in schizophrenia. Not to mention the fact that it is not the diagnosis that is treated, but the symptomatology. Therefore, if there is a suspicion of the presence of this disease, it is best to consult a specialist. Communication within the framework of a consultation and a hospital is already a diagnostic technique and is called a clinical conversation.

    Also, pathopsychological research, which is carried out by a clinical psychologist through conversation and various diagnostic techniques, can shed light on internal mental processes. Within the framework of such a study, a diagnosis is not made, but an assessment of mental processes is given by a number of indicators, which can significantly help in the diagnostic process.

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