Only about 10 to 20 percent of people treated for schizophrenia don’t experience a relapse, according to a review published in the journal BMC Psychiatry in 2013. Most people with schizophrenia have multiple relapses over time. “Complete remission of schizophrenia symptoms is uncommon," says Sophia Frangou, MD, PhD, a psychiatry professor at the Icahn School of Medicine at Mount Sinai Hospital in New York City. “Most people will experience a gradual recurrence of symptoms.” Warning Signs of a Schizophrenia Relapse Some schizophrenia relapses occur without warning, but when early signs are present, they’re usually a return of symptoms that have occurred in the past. Common warning signs of a schizophrenia relapse include insomnia, social withdrawal, difficulty concentrating, loss of interest, increasing paranoia, and hallucinations. Knowing these symptoms is important, but knowing the symptoms that are specific to each person with schizophrenia — called “relapse signatures” — is more important. Up to 70 percent of people with schizophrenia will experience these early symptoms before a full relapse sets in. “These warning symptoms can be very specific,” says Michael T. Compton, MD, MPH, chairman of psychiatry at Lenox Hill Hospital in New York City. “For one person, it may be insomnia or worries about the neighbors. For another person, it may be irritability or hearing whispers.” In fact, warning signs may be as specific as avoiding a certain food or color, Dr. Frangou says. That’s why it’s important to know the symptoms of previous episodes and to watch for them. “The first sign of a relapse is repeating symptoms of a previous episode,” Frangou says. The first symptoms of schizophrenia onset may develop over months or years. Relapse tends to happen more quickly. According to the BMC Psychiatry review, the average time from return of symptoms to a full relapse is less than one month. Recognizing these symptoms early on can help immediate steps be taken to get proper treatment. Common Causes of a Schizophrenia Relapse Knowing the common causes of a schizophrenia relapse can tell you when to be on the lookout for a relapse of symptoms. Not taking medication regularly or as prescribed is by far the most common cause of schizophrenia relapse. Persistent use of drugs or alcohol and criticism from caregivers are next on the list. “Many people with schizophrenia abuse some type of drug, most commonly marijuana,” Frangou says. Stress is particularly problematic. “Stress may contribute to schizophrenia relapse, but symptoms of relapse can also increase stress,” she says. First Steps to Take If a Schizophrenia Relapse Occurs “You may not be able to prevent a schizophrenia relapse, but early recognition and treatment may prevent a hospital admission,” Dr. Compton says. “The first thing to do is call the person’s doctor to find out if his or her medication needs to be adjusted or restarted.” Other strategies include:
Staying on medicationAvoiding stressAvoiding drugs and alcoholSleeping and eating wellNot withdrawing from friends and loved onesHaving a social support systemGetting psychosocial treatments
Psychosocial treatments help people with schizophrenia and their families learn how to live with the condition. They include individual, group, or family education as well as counseling. “Increasing psychosocial treatments can be an important part of relapse prevention,” Compton says. You may not always be able to prevent a schizophrenia relapse, but recognizing relapse symptoms and getting help early can help prevent a more severe episode.
