Schizophrenia : Course of Illness

Schizophrenia is a chronic disorder that begins early in life and has a poor long-term outcome.

Stages of Schizophrenia:

1. Prodormal Phase:

This phase typically lasts for months to years. Main features are Social Withdrawl & deterioration in Personal Hygiene.

2. Active Phase:

Psychotic Symptoms develop in this phase which include Hallucinations, Delusions or Disorganised Speech or Behaviour.

3. Residual Phase:

Active phase is followed by Residual phase. It is similar to prodormal phase. Some of the psychotic symptoms may persist during this phase but at a lower level of intensity which may not be as troublesome to the patient.


The classic course of schizophrenia is one of the exacerbations and remissions. After the 1st episode, patient gradually recovers and may then function relatively normally for a long time. Further deterioration in the patient’s baseline functioning follows each relapse. This failure to return to baseline after each relapse was historically thought to be the primary distinction between schizophrenia & mood disorders.

Positive symptoms tend to become less severe with time but negative symptoms may increase in severity.

**Schizophrenia affects multiple aspects of a patient’s life. However, some patients have a relatively good outcome and do not experience the severe deterioration.

***Less developed countries (INDIA) tend to have a better outcome than developed countries. It may be because Schizophrenic patients are better accepted in less developed societies & are more likely to be taken care of by family members.


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