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Residual schizophrenia is the mildest of the five types of schizophrenia. Individuals who are diagnosed with residual schizophrenia are often in a transitional stage of the disorder.
Their clinical history includes at least one full-blown episode of schizophrenia, during which they met the criteria for one of the other four types. However, as the name implies, the symptoms that are currently present are “residual” rather than dominant.
Patients who meet the criteria for residual schizophrenia are still showing some signs of their illness, but they don’t have any prominent positive symptoms. Positive symptoms of schizophrenia include hallucinations, delusions, catatonic behavior, severely disorganized behavior, or disorganized speech. They must, however, be exhibiting some negative symptoms (e.g. limited verbal expression, loss of initiative, or little to no expression of emotions) or at least two or more diminished positive symptoms, such as magical thinking, odd behavior, or somewhat disorganized speech.
In many cases, residual schizophrenia is only a temporary phase of the bigger clinical picture. The schizophrenic individual may be transitioning from an acute psychotic episode to a period of full remission, or vice versa. However, this isn’t always the case. The individual may have been in a period of remission, and then something triggers the flare-up of mild symptoms but not another acute episode. The symptoms of residual schizophrenia may vary in terms of duration. For some patients, they last for only a short period of time. Others, however, may remain in a residual phase for several years.
If a patient currently meets the criteria for any of the other four types of schizophrenia, then a diagnosis of residual schizophrenia cannot be made. The diagnosis may also change from time to time, depending on the symptoms that are present during any particular evaluation.
Although individuals with residual schizophrenia are much less impaired than those diagnosed with one of the other four types, ongoing treatment is still necessary.
Treatment will often include the continuance of antipsychotic medication in order to manage current symptoms. Antipsychotic medication will also help reduce the risk of a recurrence of a full-blown psychotic episode. Other types of medication, such as antidepressants or mood stabilizers, may be necessary to treat co-occurring symptoms of anxiety or a mood disturbance.
It’s important to note that, in some cases, an episode of residual schizophrenia may be triggered when medication is discontinued.
For example, if a patient diagnosed with paranoid schizophrenia is doing well on a particular antipsychotic medication and then stops taking it for whatever reason, mild (residual) rather than acute symptoms may begin to appear over time. This is why it’s essential that patients with a history of schizophrenia continue their medication as prescribed. Learning to manage stress, developing a strong support network, and participating in other types of treatment (listed above) will also help reduce the risk of future acute episodes.
Medication is not the only type of treatment for residual schizophrenia. As with other types of schizophrenia, non-pharmaceutical types of treatment may include:
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