the stages of schizophrenia
The Stages of Schizophrenia

Learn about the stages of schizophrenia and what happens during each one. What symptoms appear? How do they differ from each other? Are they following an order?

Do you know the stages of schizophrenia? People with this psychotic spectrum disorder often go through five. In this article, we will talk about the characteristics and symptoms of each of them. In addition, we will see why it is so important to act in certain specific phases.

According to the WHO (World Health Organization), schizophrenia is a serious mental disorder that affects more than 21 million people worldwide. It is more common in men (12 million) than in women (9 million) and men also develop it at an earlier age.

The stages of schizophrenia

We are now going to discover the phases of schizophrenia; these are contrasting phases and accepted by experts. Most people with this serious mental disorder go through them all.

In fact, the American Psychiatric Association (APA, 1999) recognizes four phases of schizophrenia: 1) prodromal phase, 2) acute phase, 3) stabilization phase, and 4) stable or residual phase. We will talk here about five phases because we will differentiate the stable phase from the residual phase.

Prodromal phase

The first of the phases of schizophrenia is the prodromal phase; during it, the patient begins to experience the first symptoms of the disease, which predate the acute or active phase.

This is a vitally important phase because if we work on it, we can reduce the risk of psychotic breakdown or prevent relapses of the disease. In other words, we can prevent this phase from leading to the next one (active phase). It is not easy: for this, we must be attentive to the characteristic symptoms of the prodromal phase. These are:

Concentration difficulties.

Nervousness or restlessness.
Alterations/disorders of schedules and routines (going to bed, getting up, etc.).
Symptoms of sadness and depression.
Eating disorders (frequent lack of appetite).
Sleep disturbances (eg, insomnia).
Social isolation (stopping seeing friends, for example).
Beginnings of anhedonia (not liking things).
Feelings of worthlessness.
Worrying about things, rumination.

Some people have only some of these symptoms. Logically, it is not necessary to present them all to move to an active phase of the disease. Of course, the more symptoms there are, the more possibilities there are for triggering the psychotic breakdown or illness (or relapse).

It is important to note that the more the patient suffers from relapses, the greater the deterioration that he undergoes; it will therefore be very important to work in the prodromal phase of schizophrenia and to be attentive to the symptoms mentioned.

Active/acute phase

The second of the phases of schizophrenia is the active phase (also called the acute phase). During this phase, the patient can be said to have entered into a crisis or suffered a psychotic crisis. This is where the positive symptoms of schizophrenia appear intensely, which, it should be remembered, include: hallucinations, delusions, disorganized thoughts and language, etc.

This phase is characterized by the fact that the behavior of the individual changes a lot; it becomes unbalanced and disorganized. In addition, the behavior can become challenging and strange. Thus, the typical symptoms of the acute phase are as follows:

Positive symptoms of schizophrenia (already mentioned).

Distrust of others, reaching paranoia.
Strange and disorganized behavior.
The length of this phase can vary greatly from person to person. However, the same person usually has psychotic episodes (active phase) that are all of the same duration. During this phase, the person usually needs to be hospitalized due to the severity of the symptoms.

Stabilization phase

The stabilization phase is also called the recovery phase. During this phase, the psychotic symptoms decrease in intensity. This is the period that begins once the previous phase has resolved, i.e. the acute phase. This usually occurs when the patient begins to respond satisfactorily to treatment.

The objective of this phase is twofold: to avoid relapses and to improve the symptoms that are still present. The average duration of this phase would be 6 months.

“There is no stability without solidarity, nor solidarity without stability. »

-José Manuel Barroso-

Residual phase

During this phase, also called the post-crisis phase, the negative symptoms of schizophrenia appear to a varying degree. One of the possible complications found during this phase is the onset of post-crisis depression. During this phase, and with depression, suicide prevention will be vitally important.

What are the negative symptoms of schizophrenia mentioned that appear during this phase? Let’s list the most important:


Alogy is an impoverishment of thought; it involves slow and undeveloped alternative thinking. In addition, the language of the person with schizophrenia and this symptom are usually stereotyped, repetitive and poor.


Implies a lack of interest and desire for things. In other words, it’s not wanting to do anything. There is an absence of concerns and goals (however small).


Anhedonia is the lack of pleasure in things that used to make us happy.

A meta-analysis by Savill et al. (2014) published in the journal Psychological Medicine suggests that negative symptoms of schizophrenia show a significant reduction over time, regardless of the type of intervention performed. In the meta-analysis, the reduced symptoms were specifically observed to be alogy, abulia, apathy, emotional blunting, and social isolation.

The most attenuated symptoms were abulia and apathy.

Stable phase (asymptomatic)

The last of the phases of schizophrenia is the stable or asymptomatic phase. This is the “wanted” phase because the patient is stable and without symptoms (or with very mild symptoms). When symptoms appear, they are usually anxiety, depression, tension and/or insomnia, according to Therapeutic Guide for the Management of Schizophrenia.

This is a good step for the psychologist to provide the patient with the necessary tools to prevent relapses and maintain adequate functioning and a good degree of well-being. When this phase collapses, i.e. the patient decompensates again, we then enter another of the phases of schizophrenia: the acute phase (psychotic breakdown).

That is why performing work at this time will also be of great importance to accompany the patient throughout his journey. Pharmacologically, the medication will also be of great importance here (as in all phases).

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Vogue Health Team


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