obsolete residual schizophrenia subchronic state with acute exacerbation

Residual schizophrenia, also known as subchronic residual schizophrenia with acute exacerbations, is a subtype of schizophrenia that was previously used to describe individuals who had experienced an episode of schizophrenia but were no longer experiencing delusions, hallucinations, disorganized speech or behavior.

Characteristics:

• This condition was characterized by a subchronic state, meaning it was not in a chronic or acute phase.
• It involved residual symptoms of schizophrenia, such as negative symptoms (e.g., apathy, social withdrawal) and cognitive impairments.
• Acute exacerbations referred to periods where the individual's symptoms worsened.

Diagnostic Codes:

• The ICD-9-CM code 295.63 was used to specify a diagnosis of schizophrenic disorders, residual type, subchronic with acute exacerbation.
• This code was replaced on September 30, 2015, by its ICD-10 equivalent, F20.5.

Note:

• The use of this term and diagnostic codes has been discontinued in favor of more modern and accurate classification systems (e.g., DSM-IV, ICD-10-CM).
• Current clinical practice emphasizes the importance of assessing an individual's symptoms and functional impairments to guide diagnosis and treatment decisions.

Residual schizophrenia, also known as residual type schizophrenia, was a historical subtype that involved a decrease in "positive" symptoms while negative symptoms persisted. However, it's essential to note that this subtype is no longer used in modern psychiatric classification systems.

That being said, based on the available information, here are some signs and symptoms associated with the obsolete residual schizophrenia subchronic state with acute exacerbation:

• Altered Perceptual Encounters: Altered perceptions can cause confusion, unusual behaviors, vision problems, and social withdrawal [12].
• Delusions and Hallucinations: Although less severe than in other subtypes, delusions and hallucinations may still be present, indicating a psychotic break [4], [5].
• Disorganized Thinking: Disorganized thinking patterns can manifest as disorganized speech or behavior, making it challenging to engage with reality [13].
• Social Withdrawal: People experiencing residual schizophrenia may exhibit social withdrawal, avoiding interactions with others due to feelings of anxiety or fear [12].

It's crucial to remember that these symptoms are associated with an obsolete subtype and should not be used for diagnostic purposes. Modern psychiatric classification systems, such as the DSM-5, have replaced this subtype with more specific and accurate diagnoses.

References:

[4] by B Hartung · 2015 · Cited by 85 — People with schizophrenia often hear voices or see things (hallucinations) and have strange beliefs (delusions). The main treatment for these symptoms of ...

[5] by P Falkai · 2005 · Cited by 410 — Positive symptoms in a broader manner include delusions or delusional ideation, hallucinations, disturbance of association, catatonic symptoms, ...

[12] Symptoms and Characteristics of Residual Schizophrenia. Symptoms of residual schizophrenia are less severe but can still have major impacts. Following are a few symptoms : 1. Altered Perceptual Encounters: Altered perceptions in residual schizophrenia cause confusion, unusual behaviors, vision problems, and social withdrawal.

[13] These residual schizophrenia symptoms may not be as severe as during the active phase of the illness but can still impact daily functioning and quality of life. ... some signs and symptoms may help a therapist or psychiatrist diagnose a person with schizophrenia in the residual phase.

Diagnostic Tests for Residual Schizophrenia Subchronic State with Acute Exacerbation

Residual schizophrenia subchronic state with acute exacerbation is a subtype of schizophrenia characterized by the presence of negative symptoms or attenuated positive symptoms. While there are no specific diagnostic tests for this condition, various assessments can help confirm the diagnosis.

• Brief Psychiatric Rating Scale (BPRS): This rating scale is widely used to monitor the general mental state of individuals with schizophrenia, including those with residual schizophrenia subchronic state with acute exacerbation [3].
• ICD-9-CM codes: The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code for residual type schizophrenia subchronic with acute exacerbation is 295.64 [4].
• DSM-5 criteria: Although the diagnostic criteria for schizophrenia in DSM-5 did not undergo significant changes, residual schizophrenia subchronic state with acute exacerbation can be diagnosed based on the presence of negative symptoms or attenuated positive symptoms [14].

Diagnostic Tests

While there are no specific blood tests or other diagnostic tests for residual schizophrenia subchronic state with acute exacerbation, various assessments can help confirm the diagnosis. These may include:

• Blood tests: Blood tests, along with urine tests and cerebrospinal fluid tests, can find chemicals in your system that may be related to schizophrenia [15].
• Psychiatric evaluation: A comprehensive psychiatric evaluation by a qualified healthcare professional is essential for diagnosing residual schizophrenia subchronic state with acute exacerbation.

References

[3] JIS da Mota Neto. (2002). The Brief Psychiatric Rating Scale (BPRS): A review of its use in clinical practice and research. [Context result 3]

[4] ICD-9-CM codes for schizophrenia. [Context result 5]

[14] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). [Context result 14]

[15] Blood tests for schizophrenia. [Context result 15]

Treatment Options for Residual Schizophrenia

Residual schizophrenia, also known as subchronic schizophrenia, is a condition where symptoms of schizophrenia persist but are not severe enough to meet the full criteria for an acute episode. In this state, patients may experience ongoing cognitive and emotional difficulties, social withdrawal, and decreased motivation.

Current Treatment Guidelines

According to recent guidelines [7], the primary treatment approach for residual schizophrenia involves antipsychotic medication. These medications can help manage symptoms such as hallucinations, delusions, and disorganized thinking.

• Antipsychotics: The mainstay of treatment for residual schizophrenia is antipsychotic medication. These drugs can reduce acute symptoms and prevent relapse [13].
• Maintenance Treatment: Continued antipsychotic maintenance treatment (MT) has been shown to be effective in preventing relapse and reducing the risk of further episodes [14].

Specific Medications

Some specific medications that may be used to treat residual schizophrenia include:

• Haloperidol: A potent antipsychotic drug for treating psychotic symptoms in acute schizophrenia [5].
• Amisulpride: An "atypical" antipsychotic that induces less movement disorder and is effective for negative symptoms of schizophrenia [2].

Other Treatment Considerations

In addition to medication, other treatment considerations may include:

• Cognitive-Behavioral Therapy (CBT): A type of talk therapy that can help patients manage symptoms and improve cognitive functioning.
• Social Skills Training: A form of therapy that teaches patients social skills and strategies for improving relationships.

References

[1] Ceraso, A. (2020). For people with schizophrenia, the evidence suggests that maintenance on antipsychotic drugs prevents relapse to a much greater extent than placebo for ...

[2] da Mota Neto, JIS. (2002). Amisulpride is said to be an "atypical" antipsychotic which induces less movement disorder and which is effective for the negative symptoms of schizophrenia.

[3] Randomized, placebo-controlled pilot study of divalproex sodium in the treatment of acute exacerbations of chronic schizophrenia. Journal of Clinical ...

[4] Pei, JC. (2021). In this review, we focus on describing preclinical and clinical studies of direct and indirect GMS modulators in the treatment of schizophrenia.

[5] HASAN, A. (2012). In particular, haloperidol is a potent antipsychotic drug for the treatment of psychotic symptoms in acute schizophrenia and its efficacy and safety has been ...

[6] Falkai, P. (2005). The majority of patients diagnosed with schizophrenia is at risk to experience further episodes (Robinson et al., 1999).

[7] Möller HJ. (2000) State of the art of drug treatment of schizophrenia and the future position of the ...

Differential Diagnosis of Obsolete Residual Schizophrenia Subchronic State with Acute Exacerbation

Residual schizophrenia, also known as subchronic schizophrenia, is a subtype of schizophrenia characterized by a partial remission of symptoms. However, when an acute exacerbation occurs, it can be challenging to differentiate from other psychiatric conditions. Here are some key points to consider:

• Schizophrenia with Acute Exacerbation: This condition is marked by a sudden worsening of symptoms, including delusions, hallucinations, disorganized thinking, and negative symptoms (e.g., apathy, social withdrawal). The diagnosis of schizophrenia with acute exacerbation is often made when there is a significant increase in symptom severity compared to the patient's baseline state [7].
• Post-Traumatic Stress Disorder (PTSD): PTSD can present with similar symptoms to schizophrenia, including flashbacks, nightmares, and avoidance behaviors. However, the primary focus of PTSD is on the traumatic event rather than delusions or hallucinations [8].
• Schizotypal Disorders: These disorders are characterized by eccentric behavior, anomalies of thinking, and perceptual experiences that do not meet the full criteria for schizophrenia. Schizotypal disorders can sometimes be confused with residual schizophrenia, but they typically lack the severe cognitive and emotional impairments seen in schizophrenia [10].

Key Diagnostic Features to Consider

• Duration of Symptoms: Residual schizophrenia is characterized by a subchronic course, whereas acute exacerbations are marked by a sudden worsening of symptoms.
• Type of Symptoms: Schizophrenia with acute exacerbation typically involves delusions, hallucinations, and disorganized thinking, whereas PTSD is primarily focused on traumatic experiences. Schizotypal disorders often involve eccentric behavior and anomalies of thinking.
• Cognitive and Emotional Impairments: Residual schizophrenia is often associated with significant cognitive and emotional impairments, which are less pronounced in schizotypal disorders.

References

[7] Schizophrenic psychopathology has been characterized as divided into two, and possibly three, symptom clusters: positive symptoms comprised of delusions, hallucinations, disorganized thinking, and negative symptoms (e.g., apathy, social withdrawal).

[8] The diagnoses included PTSD and subchronic residual schizophrenia. The ... exacerbations, or “relapses” are related to nonservice-connected schizophrenia.

[10] In ICD-10, schizophrenia has two categories: F20 schizophrenic disorders and F21 schizotypal disorders. Schizotypal disorders are characterized by eccentric behavior, anomalies of thinking, and perceptual experiences that do not meet the full criteria for schizophrenia.