How does schizophrenia occur in women?

In the prodromal period, some eccentricity of behavior is usually attributed to the characteristics of the character, and they are not paid attention to. Yes, and not one psychiatrist will not be able to declare a person a schizophrenic and begin treatment before the appearance of the main signs, and these are delusions and hallucinations.

The disease can occur in different forms: continuous, when the symptoms are constantly observed from the moment of their appearance and the progress of the disease occurs slowly and gradually; paroxysmal or recurrent, when the occurrence of distinct seizures accompanied by affective disorders is characteristic, and between them there are gaps of enlightenment (remission), often quite long with a high level of working ability and almost complete social adaptation. The intermediate form is paroxysmal progredient schizophrenia - the emergence of more and more complex affective attacks on the background of a continuous course.

In the overwhelming majority of cases, schizophrenia manifests itself in 5-7-10 years later than in men, perhaps this is due to its lighter course, which is noted by most authors. After 25 years, usually a woman has already received education, began to build a career, most of them have already had a family. In addition, women are more inclined to seek help for feelings of mental distress, they are more willing to have a dialogue with a doctor and fulfill his appointments because they want to recover, work, raise children and enjoy life. There is even the opinion that it is possible to help only those who want this help, who have something to return to in the real world. Perhaps all of these factors and lead to the fact that women often suffer from low-grade (low-intensity) schizophrenia, characterized by a relatively favorable prognosis, with gradual formation of shallow personality changes.

The symptoms of mild schizophrenia in women are the same as the disease is the same, only more easily expressed. Symptomatology is not distinguished by distinct psychotic phenomena, but disturbances of the neurosis-like type prevail - absurd obsessions, fears, for example, objects of a certain shape or color, sometimes rather complex rituals; psychopathic, for example, hysteria, emotional coldness, deceit, hyperexcitability, vagrancy; other affective disorders.

A woman can become indifferent, indifferent to relatives and her children, sloppy, the desire to work and to rest actively disappears. It is the development of hypochondria that is inherent in women, more often she begins to listen to herself, to seek out non-existent diseases in herself, however, she can focus her attention on the health of her relatives, and even more so on children, taking them out with her hypertrophied "liver".

The danger threatening not only the patient, but also to members of her family is also a fairly common subject of delirium. The patient becomes alert, suspicious, and sometimes aggressive to those whom she counted as enemies in the camp. Mania of persecution is one of the characteristic manifestations of schizophrenia in persons of either sex.

For women, the fascination with magic, occult sciences is characteristic, they can become very zealous parishioners of any religious denomination.

Symptoms can be different, their main feature is the obvious improbability of statements. The patient in any case shows an enviable persistence in his convictions, which are not amenable to any logical beliefs. Her obsessive thoughts, insomnia, constant anxiety. She performs certain protective ritual acts that soothe her for a while. Even such a strongly developed instinct in women as motherhood weakens.

To diagnose schizotypal disorder (sluggish schizophrenia), a psychiatrist usually pays attention to oddities in behavior, eccentricity and eccentricity, mannerism, the speech of the patient, which is characterized by flatulence and mistrust in poverty and inadequacy of intonation.

Under the influence of strong and not shared by anyone experiences, the patient may develop a craving for alcohol, drugs, drug addiction.

The course of schizophrenia may be paroxysmal or permanent and progressive. The second type of flow is more characteristic for the absence of treatment. With timely treatment, the symptoms often subside, and the woman leads a very normal life.

Exacerbation of schizophrenia in women can occur in a variety of stressful circumstances, in the presence of somatic diseases, under the influence of changes in hormonal levels. Sometimes after a debut at a young age, schizophrenia can only worsen in old age due to the development of age-related changes in the brain and / or chronic somatic pathologies and their intensive drug treatment.

Kinds

 

[1], [2]

Stages

This disease is characterized by the involution of mental functions, disorganization of the mind, lack of logic in behavior, loss of its harmony. The cleavage of the mind is manifested in the fact that with the preservation of acquired intellectual baggage, it is disturbed, and quite roughly, a different mental activity - thinking, emotions, feelings, motility. As a result of a long paroxysmal or continuous flow, personal autistic changes occur, the person becomes more and more locked in himself and on his thoughts and experiences that are known only to him. This is a serious disease affecting the structure of the brain and metabolic processes in its cells.

The development of schizophrenia, like other serious chronic diseases, occurs in stages. Basically, it is a long process. Each stage extends over years, with the exception of cases of early manifestation, which are distinguished by the rapid passage of the first two stages and the appearance of signs of degradation.

In the prodromal period, you can notice some nonspecific oddities of behavior, but schizophrenia can only be diagnosed from the onset of obvious symptoms. They appear in the first stage of schizophrenia and gradually seize the mind of a sick woman. This stage is called mastering. There are hallucinations and / or nonsense, that is, the patient goes into a new world for her. As the memory is preserved, she realizes that she has changed herself and everything around. The first stages of schizophrenia open to the patient a new one and, as it seems to her, the true meaning of the events taking place, she sees through the people around her, her intrigues and insidious designs become clear to her, or she feels her power and messianism due to the fact that only she knows bring happiness to humanity, or at least - your family. Unusual for the patient condition accompanied by severe depersonalization  / derealization. The initial stage of schizophrenia in women is often accompanied by severe affective symptoms. Depending on the content of delusions and hallucinations, there are signs of depression or mania. At the first stage, the body mobilizes all its resources to fight, so the manifestation usually takes place quite violently. If the treatment is started during this period, it is highly likely that it will end in a long remission, and the patient will return to normal life.

In the second stage, adaptation to the disease occurs. Novelty is lost, the patient becomes accustomed to voices, he knows everything about the intrigues of his enemies or his great mission, he becomes accustomed to dualism - the reality of the environment quite peacefully gets on in consciousness with illusions. The second stage is characterized by certain repeated behavioral stereotypes — ritual actions that help the patient to simply live. The result of treatment at this stage, according to psychologists, depends on what world the patient chooses for herself and whether she wants to return to what is waiting for her in reality.

The third, last, stage marks the degradation - emotional and mental. With successful timely treatment or mild disease, some patients cannot reach the advanced third stage, fortunately. At this stage of the disease hallucinations become dull, the delirium fades away, the patient withdraws into herself. There is a depletion of brain activity, the behavior is becoming increasingly stereotypical - the patient can wander around the room all day or sit, swaying from side to side, just lying, looking at the ceiling. There may be motor dysfunctions. However, even in the third stage, a strong shock can temporarily return the patient to reality.

[3], [4]

Forms

Currently, the International Classification of Diseases identified eight specified types of schizophrenia. In the next classifier, they will no longer exist, and in DSM-V they no longer exist, since the type of disease has no value for treatment or for prediction, besides, numerous studies conducted did not reveal any differences in the course features and response to antipsychotic medication depending on the type of schizophrenia.

However, while the new classifier has not been adopted, and various forms of schizophrenia are still being diagnosed, let us review them briefly.

Paranoid schizophrenia manifests in women aged 25-35 years, sometimes later. The most common. It has a continuous flow, it develops gradually, personal changes occur slowly. The most pronounced symptoms are persistent paranoid delusions of a relationship, influence or influence. The patient is sure, for example, that she is followed everywhere, without taking her eyes off. She "sees" how the observers transmit it to each other, they talk about her, shine through it, cause damage, "understand" that serious organizations have organized surveillance - the CIA, aliens, Satanists... Begins to suspect their friends, interpret the words they say in their own way. Later, auditory hallucinations join in — the patient hears voices, sometimes not one, in her head there are thoughts that are completely peculiar to her previously, but as if inserted from outside. The most unfavorable are imperative voices, on the orders of which patients can perform life-threatening actions. Over time, the syndrome of mental automatism is formed, orders and internal dialogues determine the behavior of the patient and acquire the greatest importance for her. The patient may have and usually have other symptoms, such as emotional coldness, motor and speech disorders, but they are mild, and the hallucinatory-paranoid syndrome prevails. Paranoid schizophrenia in women is usually recognized quickly, because in most cases the delusions are unreal and ridiculous. However, sometimes the nature of delirium is plausible, for example, jealousy, and patients - very convincing. In such cases, for quite a long time, the surrounding people may not know about the disease, and the patient's condition may worsen.

Chronic schizotypical (schizophreniform) disorder or, as it was previously called, sluggish schizophrenia in women develops most often. The symptoms of this disease are about the same as those of true schizophrenia, however, it does not reach its height. Paranoid symptoms - delirium and hallucinations can be, but unstable and mild. More often there are obsessions, oddities in behavior, rituals, excessive thoroughness, self-centeredness and detachment, hypochondria, dysmorphophobia are noticed. Imaginary complaints of patients differ in pretentiousness (steam bubbles in the lungs, water gurgles in the brain), patients cover their supposedly ugly chin with a scarf, or measure the length of the ears every day, because it seems to them that one of them is growing. However, negative consequences in the form of deep emotional burnout, as well as social and professional maladjustment in case of disorder do not appear. This atypical form of the disease is also called latent schizophrenia in women.

The role of the hereditary factor in the incidence is very large, its presence can be traced in almost all cases, with the exception of the debut in old age, when it is sometimes impossible to trace the family history. Hereditary schizophrenia in women, although rarely can manifest in childhood and adolescence (12-15 years). This earlier onset suggests a severe progressive course and the rapid development of negative symptoms. The following are considered to be the types of juvenile malignant schizophrenia:

Catatonic - is characterized by the predominance of diametrically opposed psychomotor disorders in symptoms, usually proceeding without stupefaction (immobility is replaced by hyperkinesis). When she awoke, the patient remembers and can tell about what was happening around her. Periodic freezing episodes precede a stupor, for example, patients are standing or sitting, looking at one point. With this type of disease, oneiroid states can develop. This form of schizophrenia is characterized by a rapid course - the third stage occurs within two to three years.

Herbefrenic schizophrenia in women develops extremely rarely, such a diagnosis is made only in adolescence and early adolescence. It has a rapid development and poor prognosis due to the development of autistic disorder. The dominant signs are absolutely inappropriate grimacing and silly behavior.

The simple form is also not typical for female patients, as it develops early, the first two stages are asymptomatic in the absence of psychosis. Then, quite unexpectedly, negative symptoms begin immediately and a gross personal restructuring, accompanied by pronounced psychosis. Simple schizophrenia develops without delusions and hallucinations; moreover, such children usually do not cause any complaints to their parents or teachers before the illness. Changes in behavior appear suddenly and are expressed in a rapid increase in symptoms. In three to five years, a special schizophrenic defect develops in patients, consisting in complete indifference to everything.

Manic schizophrenia in women is characterized by the presence of an elevated background mood, which does not decrease even when there are real reasons for it; tachypsychia - accelerating the pace of thinking (the patient becomes just a generator of ideas); Hyperbulia - increased activity (motor, motivating, especially in terms of pleasure, a multi-faceted and fruitless activity). This type of schizophrenia is not distinguished in classifiers, mania is an additional symptom, however, it is characteristic for women. The intensity and severity of each of the symptoms can vary, moreover, schizophrenics usually have complex manic-paranoid disorders in combination, for example, with delusions of persecution or relationships, nonsense of their own exclusivity. Oneiric mania may develop in combination with bright hallucinations. Manic states relate to mood disorders, that is, an affect, under the influence of which the patient's need for rest is reduced, a lot of unreal plans and ideas appear, she can develop vigorous activity in many directions. Mania is not always associated with a joyful mood, often hyperactivity of thinking and motility is accompanied by a decrease in mood, increased irritability, aggressiveness and anger. The patient can go all serious, having a sexual marathon, addicted to drugs or alcohol.

The use of psychoactive substances exacerbates the picture of the disease. There is no such thing as alcoholic schizophrenia in women. There is the concept of alcoholic psychosis, which can develop with severe intoxication with alcohol, or as delirium as a result of the abolition of alcohol. Its symptoms resemble an attack of schizophrenia - delirium, hallucinations, automatic behavior appear, however, these are etiologically different diseases. Schizophrenia can be complicated by alcoholism, but one cannot become schizophrenic on the basis of alcoholism, at least for the time being, schizophrenic-like symptoms, which appear only on the basis of alcoholism, are considered and delimited.

Affective schizophrenia in women is also an incorrect concept, despite the fact that in women, depressions and mania are additional symptoms. However, patients with extensive indicated symptoms are not diagnosed with schizophrenia until it turns out that its symptoms preceded the appearance of, for example, manic-depressive psychosis or major depression.

[5], [6]