What Is Residual Schizophrenia?

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Residual schizophrenia is one of the five subtypes of schizophrenia. People with residual schizophrenia aren't currently experiencing the positive symptoms of schizophrenia, such as delusions, hallucinations, or disorganized behavior.

However, they continue to experience a reduced form of one or two of these symptoms, such as strange perceptions or distorted thinking, along with the negative symptoms of schizophrenia, including social withdrawal, blunt affect, or difficulty paying attention.

The following article will first explain what schizophrenia is before outlining the disorder's symptoms, causes, and treatment options. It will also discuss ways that both people with schizophrenia and those who love them can cope with the realities of the disorder.

What Is Schizophrenia?

Schizophrenia is a chronic mental illness marked by difficulty discerning what is real from the false perceptions inside one's head.

Symptoms of schizophrenia include delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms, such as diminished emotional expression and decreased motivation to engage in activities.

People with schizophrenia often have trouble maintaining the same level of functioning in areas like work, interpersonal relationships, and self-care as they did prior to the onset of their symptoms.

Subtypes

Up until the most recent version of the American Psychiatric Association's Diagnostic and Statistical Manual, the DSM-5, which was published in 2013, schizophrenia was divided into five subtypes:

  1. Paranoid: People with paranoid schizophrenia experience at least one delusion or frequent auditory hallucinations.
  2. Disorganized: The symptoms of disorganized schizophrenia include disorganized thought, disorganized speech, and flat affect.
  3. Catatonic: In addition to other symptoms of schizophrenia, people with catatonic schizophrenia also experience catatonia, which may include unresponsiveness or restlessness.
  4. Residual: In people with residual schizophrenia, symptoms of schizophrenia still exist but are weaker than in other subtypes.
  5. Undifferentiated: If symptoms from more than one of the other subtypes of schizophrenia are present, but there aren't enough to classify the individual in another subtype, they meet the criteria for undifferentiated schizophrenia.

Limited evidence for the clinical utility of these subtypes and lack of stability among them due to the variable course of schizophrenia led to their elimination from the DSM-5 in favor of using a spectrum to rate symptom severity.

Although they are no longer used to diagnose schizophrenia, many mental health clinicians still find the subtypes helpful in understanding the disorder and determining the best treatment for each individual.

It's still important to understand, though, that even if a person currently exhibits symptoms associated with one of the subtypes, their symptoms may change quickly.

Residual Schizophrenia Symptoms

While the symptoms of the other four subtypes of schizophrenia are often more extreme and include criteria such as delusions, hallucinations, disordered speech, and catatonic behavior, in residual schizophrenia, the symptoms are milder.

Although in the past, people with residual schizophrenia have experienced at least one episode involving prominent symptoms that have changed their thinking or perceptions (positive symptoms), they are no longer experiencing those symptoms. This is why symptoms in this subtype are milder.

Instead, people diagnosed with residual schizophrenia only have negative symptoms, which entail a loss or decrease in social or emotional functionor two or more mild behavioral/cognitive disturbances.

These symptoms may include:

  • Odd beliefs
  • Unusual perceptual experiences
  • Distorted thinking
  • Flat affect or diminished emotional expression
  • Lack of motivation to engage in purposeful activities (avolition)
  • Decreased pleasure from positive stimuli (anhedonia)
  • Diminished speech (alogia)
  • Lack of interest in social interaction (asociality)

Causes

Schizophrenia is a brain disorder that is thought to be caused by a number of factors, including:

  • Genetics: While schizophrenia isn't caused by genetics alone, the possibility of developing schizophrenia is over six times higher if a parent, sibling, or other close relative has been diagnosed with the condition.
  • Environmental: For people with genetic risk factors, interactions with certain kinds of environments may increase the risk that they will develop schizophrenia. Although it isn't a cause, stress can trigger schizophrenia. In addition, if an individual experiences poor nutrition or is exposed to a virus before birth, it increases their risk.
  • Brain chemistry: The brains of people with schizophrenia have been shown to differ from those without schizophrenia in several ways, including the volume of specific parts of the brain, the connections between brain regions, and the interactions between neurotransmitters, like dopamine.
  • Drug use: Taking mind-altering drugs, including marijuana, as a teen or young adult can increase the risk of schizophrenia.

Because more than one of these factors can contribute to the development of schizophrenia, it's not possible to identify what's caused it in any single individual.

Diagnosis

For a diagnosis of schizophrenia to be made, symptoms must be present for at least six months, and two or more positive symptoms must be especially pronounced for at least one month.

Schizophrenia symptoms are inconsistent, which means people may not meet the criteria for the residual subtype of schizophrenia for long.

The subtype of residual schizophrenia should not be confused with the residual phase of schizophrenia.

People with schizophrenia tend to repeatedly cycle through the phases of schizophrenia in order. These cycles end with a third phase known as the residual phase. This is the recovery phase of an episode of schizophrenia and, while there are often other symptoms, the most acute ones, such as delusions and hallucinations, have faded.

In contrast, the subtype of residual schizophrenia is a condition that, until the release of the DSM-5, could be specifically diagnosed based on the symptoms outlined above and independently of the phase of schizophrenia one is currently in.

Residual Schizophrenia Treatment

Schizophrenia usually emerges in early adulthood and has no cure. Therefore, treatment is needed to ensure people can manage the disorder. These treatments can include antipsychotic medications and therapy.

Antipsychotic Medications

Antipsychotic medications, usually administered in a daily pill or liquid, reduce the intensity and duration of schizophrenia symptoms. However, they may have side effects such as weight gain and drowsiness.

Despite these side effects, once someone starts taking antipsychotic medications, they shouldn't stop because doing so may cause symptoms to worsen.

Therapy

Cognitive-behavioral therapy is one treatment option for those with schizophrenia.

Assertive community treatment is another option. Assertive community treatment is designed for people with schizophrenia who are at high risk for homelessness and hospitalization. It also includes frequent patient contact.

Coping

Coping with schizophrenia, even the milder symptoms of residual schizophrenia, can be difficult for both the people with the disorder and their families to deal with.

For schizophrenia patients, psychosocial interventions such as behavioral skills training and supported employment can help people develop the abilities they need to pursue their goals, like going to school, finding a job, and making friends.

In addition, family support is especially important for those with schizophrenia. The more their loved ones can educate themselves about the symptoms and treatment of the condition, the better they'll be at providing support.

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5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. NAMI: National Alliance on Mental Illness. Schizophrenia. 2021.

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  5. American Psychiatric Association. What Is Schizophrenia? 2020.