Paranoid psychosis and schizophrenia are common mental disorders that have similar symptoms. This is what often causes difficulties in diagnosing and subsequent treatment of pathology. How does paranoid psychosis differ from schizophrenia? There are several differences between one phenomenon and another that must be taken into account when making a diagnosis.

Similar features

These pathologies have the following similar signs:

1. Both diseases are of genetic origin, that is, the main reason for their occurrence is hereditary predisposition.
2. Both pathologies are characterized by depressive periods and periods of increased excitability and aggression: these stages occur alternately.
3. In both schizophrenia and psychosis, changes occur at the organic level: certain areas of the cerebral cortex are affected.

What is the difference between paranoia and schizophrenia: main signs

Schizophrenia is a disease in which various delusional disorders can also occur (as with paranoid-type psychoses). However, it is precisely in psychosis that delirium is stable in nature, it is not subject to any dynamic development, and always lends itself to persistent systematics (the so-called paranoid syndrome).

In psychosis, a plot of persecution and uncontrolled jealousy arises, while hallucinogenic phenomena are not typical for such pathology (this is another difference from schizophrenic disorder).

In most cases, paranoid-type psychosis occurs in young patients; as for schizophrenia, it can occur at any stage of life.

With rare exceptions, psychosis does not exhibit symptoms characteristic of schizophrenia (automatism and apathy). Knowing these fundamental differences, a psychiatrist can distinguish one disease from another when conducting various tests during diagnosis.

Specific signs of schizophrenia

To distinguish between paranoid and schizoid manifestations, you need to know the persistent symptoms of schizophrenic disorder, which will allow you to make an accurate diagnosis. These are the main symptoms:

1. autism (a person cannot interact in society, he lives in his own, fictional world);
2. decrease in affective state (so-called emotional poverty, feeling of apathy);
3. thought disorder (violation of adequate associations);
4. feeling of interference by strangers in the thought process;
5. emotional inadequacy, committing ridiculous acts, constant inactivity.

Features of the treatment of these diseases

Since paranoid delusions are characterized by persistence of their manifestation, unlike schizophrenia, treatment is often ineffective. Specialists prescribe medications aimed at reducing anxiety, especially psychotropic drugs are needed when the patient is severely aggressive.

As for schizophrenic disorder, this condition is often characterized by depressive moods, a feeling of apathy and a catatonic syndrome (impaired motor activity, lethargy or complete lack of movement). To eliminate these symptoms, a specialist may prescribe stimulants to activate specific areas of the brain.

Possible complications

If therapy for psychosis and schizophrenia is not started in a timely manner, the diseases will progress quite quickly. As a result, constant suicidal intentions arise; the patient may show uncontrolled aggression towards others, which makes him dangerous to society.

In the later stages of the disease, patients are unable to take care of themselves and eat food on their own, so they need constant care. If the pathology is diagnosed at an early stage and effective medications are prescribed in combination with psychotherapy, during the period of remission, patients can easily lead a social life and maintain a normal mental state in an outpatient setting.

Basic measures for caring for a patient with schizophrenia and psychosis

During acute attacks, the patient must be provided with the following:

1. constant supervision and prevention of actions that may be socially dangerous;
2. interaction with the patient on the principles of cooperation and mutual understanding;
3. monitoring regular medication intake;
4. timely detection of side effects from drug therapy.

In subsequent stages, the main goal of treatment is to restore the patient’s ability to work and provide him with proper social rehabilitation. In this case, it is necessary to convince the patient to continue maintenance therapy, which will allow him to normalize his condition.

During the period of remission, it is important to involve the patient in feasible work activities and maintain the required level of social activity. At this stage, maintenance therapy is also practiced, which will prevent the onset of the acute stage.

Thus, paranoid psychosis and schizophrenic disorder are diseases that have similar symptoms and manifestations. However, they differ in the nuances of treatment, so the diagnosis must be made by an experienced psychiatrist after conducting numerous tests and interviews with the patient, as well as after analyzing somatic symptoms. In most cases, treatment of the two pathologies is carried out in an inpatient setting, with patients prescribed antidepressants and psychotropic drugs.

The concept of paranoia refers to a spectrum of interrelated and overlapping psychopathological disorders. The concept of paranoid is also not entirely correctly applied to a group of such phenomena as a passionate, unbridled desire for a social goal in otherwise apparently normal individuals.

Although such passion can be productive and disappear with the achievement of results, it is sometimes difficult to distinguish it from pathological fanaticism. At the other end of the spectrum is paranoid schizophrenia.

A paranoid character or paranoid personality is characterized by rigidity, persistence, and maladaptive patterns of perception, communication, and thinking. Traits such as excessive sensitivity to neglect and insult, suspicion, mistrust, pathological jealousy and vindictiveness are common.

In addition, persons with this diagnosis seem aloof, cold, and without a sense of humor. They can work very well alone, but usually have problems with authority and are jealous of their independence. They have a good sense of the motives of others and the structure of the group. The paranoid character differs from paranoia and paranoid schizophrenia in patterns of thinking and behavior, the relative preservation of the reality check function, as well as the absence of hallucinations and systematized delusions.

Paranoia is a psychotic syndrome that usually occurs in adulthood. Feelings of jealousy, litigiousness, ideas of persecution, invention, poisoning, etc. are often observed. Such people believe that random events have something to do with them (the concept of centrality). The person may suffer from generalized delusional or limited ideas—for example, that someone is out to harm him or that someone is having an affair with his wife. Such ideas cannot be corrected by reality testing.

Conduct problems may affect only one area, such as work or family. Paranoia often develops based on a paranoid character. Patients with paranoid schizophrenia exhibit significant disorders in relation to the outside world, based on violations of the constancy of the Self and objects, insufficient organization of mental representatives (identity) and damage to such functions of the ego and superego as thinking, judgment and reality testing. All forms of schizophrenia include psychotic symptoms.

Prodromal phase of schizophrenia characterized by the patient withdrawing into himself, after which an acute phase occurs, accompanied by delusions, hallucinations, impaired thinking (loosening of associative connections) and disorganization of behavior.

Following the acute phase, there may be residual phase, in which the symptoms weaken, but affective flatness and social maladjustment persist. As with paranoia, persons with premorbid schizoid or paranoid personality disorders, under the influence of intense stress and as a result of decompensation, regress into acute psychosis. This course of schizophrenia corresponds to Freud's ideas about the phases of care and restitution in psychosis.

Paranoid form of schizophrenia characterized by hallucinations and delusions of persecution, grandeur, jealousy, and hypochondriacal delusions. Depression, diffuse irritability and sometimes aggressiveness may be accompanied by delusions of influence (the patient’s belief that his thoughts are controlled from the outside or that he himself is capable of controlling others). The rigidity of the paranoid character may mask significant disorganization.

The general functioning of the individual in paranoid schizophrenia is less impaired than in other forms; the affective flattening is not so pronounced, and the patient is sometimes able to work. Although Freud sometimes used the concepts of paranoia and paranoid schizophrenia interchangeably, he nevertheless distinguished these forms on the basis of:

1) specific psychodynamic conflict associated with repressed homosexual desires;

2) the tendency of the ego to regression and activation of paranoid defenses.

Psychoanalysis of paranoia

The idea of ​​ego regression links his ideas about the etiology of schizophrenia with his ideas about the etiology of psychoses in general, while the emphasis on conflict in paranoia relates to his “unified” theory, which states that paranoia, like neuroses, is a defensive reaction (a compromise education).

In particular, denial, reaction formation and projection are used here and there. As formulated in Schreber's case, a conflicting unconscious desire ("I love him") is denied ("I don't love him - I hate him"), but returns to consciousness in the form of a projection ("he hates me and pursues me").

Freud also believed that, characterologically, such patients are narcissistically preoccupied with issues of power, authority, and avoidance of shame, which makes them especially prone to conflicts associated with rivalry with authorities. Delusional ideas about one's own greatness are also associated with these problems.

Freud put forward the position of massive regression to the early stages of development (fixation points), associated with the reactivation of childhood conflicts. In paranoia, fixation occurs at the narcissistic stage of psychosexual development and object relations, that is, at a higher level than in patients with schizophrenia, who regress to the objectless or autoerotic stage.

Schizophrenic regression, characterized by a tendency to abandon objects, is replaced by a restitution phase, which includes the formation of delusional ideas; the latter express a pathological return to the world of objects.

With the development of structural theory, Freud began to place greater emphasis on ego and superego factors. He believed that the withdrawal of the ego from painfully perceived external reality, accompanied by the externalization of certain aspects of the super-ego and the ego-ideal, leads to the patient’s feeling that others are watching him and criticizing him. In the pathogenesis of paranoia, he also attached greater importance to aggression.

Post-Freudians focused on the influence of aggression on development in early childhood, on internalized object relations and the formation of the Self. The quality of the emotional cathexis of images of the Self and objects and their distortion due to conflict were studied. This led to the identification of the pathogenic effects of pathological introjects. New data on the influence of aggression and shame in response to narcissistic injury have been obtained from the study of the psychopathology of narcissism.

The concept of separation-individuation made it possible to explain the development and influence of gender identity conflicts, which predispose to the emergence of a sense of vulnerability and primary femininity in men (for example, Schreber's fear of turning into a woman), which may be even more important than derivatives of homosexual conflict. Research generally confirms that homosexual conflict is predominant in paranoid schizophrenia and that it can often be found simultaneously in several family members suffering from paranoid schizophrenia.

Finally, as a result of historical research, it was found that Schreber's father showed sadistic tendencies when raising children. This indicates that Schreber's delusions contained a kernel of truth; it is now believed that this can be found in the childhood histories of many paranoid patients.

Treatment and psychotherapy of paranoia

The main condition that the psychotherapist faces with a paranoid patient is the establishment of a stable working alliance. Establishing such a relationship is necessary (and sometimes crucial) for successful therapeutic work with any clients. But they are critical in the treatment of paranoia, given the paranoid patient's difficulties with trust.

One of the novice psychotherapists, when asked about his plans for working with a very paranoid woman, replied: “First, I will gain her trust. Then I will work on developing the ability to assert my own identity.” This is a dubious plan. If the paranoid patient truly trusts the psychotherapist, the psychotherapy has already been completed and significant success has taken place. However, the colleague is right in a sense: there must be some initial acceptance by the patient that the therapist is benevolent and competent. And this will require the therapist not only to have sufficient patience, but also a certain ability to comfortably discuss his own negative feelings and tolerate some degree of hatred and suspicion directed at him by the paranoid patient.

The therapist's nonaggressive acceptance of powerful hostility helps the patient feel protected from retaliation, reduces the fear of destructive hatred, and also demonstrates that those aspects of the self that the patient perceived as evil are simply ordinary human qualities. Psychotherapeutic procedures in the treatment of paranoia differ significantly from “standard” psychoanalytic practice. The overall goals are those of understanding at a deep level, bringing awareness to unknown aspects of the self, and promoting the greatest possible acceptance of human nature.

But they are achieved in different ways. For example, the classic technique of interpretation “from the surface to the depth” is, as a rule, inapplicable with paranoid patients, since the preoccupation that they manifest is preceded by many radical transformations of the original feelings. A man who longs for the support of another man, and unconsciously misinterprets this longing as sexual desire, denies it, displaces it and projects it onto someone else, filled with fear that his wife has entered into an intimate relationship with his friend. He will not be able to properly address his actual interest if the therapist encourages him to associate the idea of ​​his wife's infidelity.

The same sad fate can befall another classic rule of psychoanalysis - “analysis of resistance before content.” Commenting on actions or attitudes made with a paranoid patient will only make him feel like he is being evaluated or studied, like a laboratory guinea pig. Analysis of defensive reactions of denial and projection only cause a more “archaic” use of the same defenses. Traditional aspects of psychoanalytic technique are exploration rather than answering questions, developing aspects of the patient's behavior that may serve as expressions of unconscious or suppressed feelings, calling attention to errors, etc. - were designed to increase the patient's access to his inner material and support his determination to talk about it more openly.

However, with paranoid patients this practice has a boomerang effect. If standard methods of helping a patient open up only cause further development of paranoid perception, how can one help? First, the patient’s sense of humor should be updated. Most psychotherapists opposed jokes in the treatment of paranoia, so that the patient did not feel pestered and ridiculed. This warning promotes safety, but does not at all exclude the psychotherapist from modeling a self-ironic attitude, making fun of the irrationality of life, as well as other forms of wit that do not belittle the patient’s dignity. Humor is essential in psychotherapy - especially with paranoid patients - since jokes are a timely way to safely discharge aggression. Nothing provides greater relief for both patient and therapist than a fleeting ray of light against the gloomy blanket of storm clouds enveloping a paranoid personality.

The best way to provide space for mutual pleasure derived from humor is to laugh at your own phobias, complaints and mistakes. Paranoid people don't miss anything. None of the psychotherapist's defects are protected from their searching gaze. My colleague claims that he has an invaluable quality for conducting psychotherapy: he can unsurpassedly “yawn through his nose.” But even he will not be able to deceive a “real” paranoid patient. One of my patients was never mistaken when she noticed my yawning - no matter how motionless my face was. I responded to her confrontation on this issue with an apologetic confession that she had again exposed me, and a regret that I was completely unable to hide anything in her presence.

This type of response advanced our work much more than the dark, humorless exploration of her fantasies the moment she thought about my yawn. Naturally, you need to be prepared to apologize if your witty joke turns out to be wrong. But the decision that work with hypersensitive paranoid patients must be carried out in an atmosphere of oppressive seriousness is unnecessarily hasty. It can be very helpful for a paranoid individual (especially after establishing a secure working alliance, which in itself may require months or years of work) to try to make fantasies of omnipotence accessible to the patient's ego with a bit of intelligent teasing.

One patient was convinced that his plane would crash on the way to Europe. He was amazed and calmed down after I remarked, “Do you think God is so unmerciful that he would sacrifice the lives of hundreds of other people just to get to you?” Another similar example concerns a young woman who developed intense paranoid fears shortly before her upcoming wedding. She unconsciously experienced the wedding as an outstanding success. This was during the time when the “crazy bomb thrower” installed his deadly weapons in subway cars. She was sure that she would die from the bomb, and therefore avoided the subway. “Aren’t you afraid of the “crazy bomb thrower?” - she asked me. And before I could answer her, she grinned: “Of course not, you only travel by taxi.” I convinced her that I use the subway and I have a very good reason not to be afraid of it. After all, I know that the “crazy bomb thrower” wants to get her, not me.”

Some psychotherapists emphasize the importance of an indirect, “face-saving” way of sharing insights with paranoid patients, recommending the following joke as a way of interpreting the negative side of projection: “A man goes to a neighbor's house to borrow a lawnmower and thinks about what a good friend he has, that capable of such favors. However, as it gets closer, he begins to have doubts about the loan. Perhaps the neighbor would prefer not to borrow the lawnmower. Along the way, doubts drive him into a rage, and when a friend appears at the door, the man shouts: “You know what you can do with your damn lawnmower - put it in your ass!”

Humor, especially the willingness to make fun of oneself, may be useful in that it is more likely to seem “reality” to the patient than the therapist playing a role and following an unknown game plan. The stories of paranoid individuals are sometimes so devoid of authenticity that the therapist's directness and honesty is a revelation about how people can relate to others. With some caveats below regarding clear boundaries, the therapist must be extremely careful with paranoid patients. This means answering their questions rather than avoiding the answer and exploring the thoughts behind the question.

In my experience, when the overt content of a paranoid person's interest is respected, he is willing to explore the latent content it presents. Often the best clue to the initial feelings from which the patient is defending himself are the feelings and reactions of the therapist himself; It is useful to imagine a paranoid personality as a person who purely physically projects relationships that are unconscious to her onto the psychotherapist. Thus, when a patient is in a state of intense, unrelenting, righteous anger, and the therapist feels threatened and helpless as a result, it can be deeply affirming for the patient to say, “I know how angry what you're dealing with is, but I feel... that in addition to this anger, you also experience deep feelings of fear and helplessness.”

Even if this assumption is incorrect, the patient hears: the therapist wants to understand what exactly brought him out of his state of mental balance. Third, patients suffering from increased paranoid reactions can be helped by clarifying what happened in their recent past that upset them. This “fallout” usually involves separation (a child went to school, a friend moved away, a parent did not answer a letter), failure, or, paradoxically, success (failures are humiliating; successes include guilt of omnipotence and fear of punishment). One of my patients was prone to long, paranoid tirades, during which I could only understand why he was reacting this way after 20-30 minutes.

If I carefully avoid confronting his paranoid actions and instead interpret that he may have underestimated how much he is bothered by something he casually mentioned, his paranoia tends to dissipate without any analysis of the process at all. Teaching a person to note his state of arousal and find the “precipitate” that caused it often prevents the paranoid process altogether. Direct confrontation of the content of the paranoid idea should generally be avoided. Paranoid patients are acutely sensitive to emotions and attitudes towards them. They become confused at the level of interpretation of the meaning of these manifestations.

If their ideas are challenged, they are more likely to think that they are being told: “You are crazy for seeing what you see,” rather than: “You have misinterpreted the meaning of this phenomenon.” Thus, it is tempting to offer an alternative interpretation, but if this is done too readily, the patient will feel rejected, neglected and deprived of insight, which in turn stimulates paranoid thoughts.

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Among all possible mental problems, schizophrenia occupies a special place.

This chronic disease, in which a person’s perception of reality and his own personality, and emotional reactions are distorted.

This disease has several varieties. The most common form of schizophrenia is paranoid.

What is low-grade schizophrenia? you will find on our website.

General concept

Paranoid schizophrenia - what is it? Paranoid (or paranoid) schizophrenia is characterized primarily by hallucinations and delusions.

At the same time, other signs of schizophrenia, such as unrelated speech, movement disorders (), if present, are practically invisible.

Paranoid schizophrenia is an independent variant of paranoid schizophrenia with a systematized monothematic delusional syndrome prolonged over a long period.

Brief History

The first mention of schizophrenia occurs back in ancient Egypt in the sixteenth century BC. Later, in the Middle Ages, Avicenna described this disease in his writings.

German psychiatrist Emil Kraepelin identified schizophrenia as an independent mental disorder.

In the twentieth century, it was finally differentiated from delirium tremens, manic-depressive psychosis and other mental disorders.

At this time, the term “schizophrenia” itself arose, derived from the Greek "mind split". The causes and methods of treating schizophrenia are still the subject of study by psychiatrists.

What is it characterized by?

Depending on which symptoms of the disease are most pronounced, paranoid schizophrenia is divided into delusional and hallucinatory.

Hallucinatory course of paranoid schizophrenia. With this type of disease, its most pronounced manifestation is hallucinations.

Hallucinations themselves are divided into several types:

• elementary visual hallucinations - appear in the form of flashes of light, lines, spots;
• objective - a person sees various objects that can either have a prototype in reality or be completely a product of the patient’s consciousness;
• zoopsia - hallucinations of birds and animals;
• autoscopic hallucination - seeing oneself from the outside or one's own;
• extracampal - the patient thinks that he sees objects that are outside his field of vision;
• senestopathy - the appearance of various, sometimes painful, sensations without a real reason;
• auditory - the so-called “voices”, which sometimes tell the patient what to do.

Less common are taste or olfactory hallucinations.

Delusional course of paranoid schizophrenia. With this option, the patient experiences a continuous development of various delusional ideas. This may be a delusion of persecution, when the patient is convinced that he is being monitored by the special services, a delusion of jealousy, a delusion of invention, and others.

What are the features of the hebephrenic form of schizophrenia? Find out about this from ours.

The difference between paranoia and schizophrenia

What is the difference between paranoia and schizophrenia?

Paranoia is a state of the human psyche accompanied by delirium. In patients suffering from schizophrenia, paranoid delusions are one of the symptoms, sometimes the most pronounced.

However, the presence of paranoia does not always indicate schizophrenia.

There are a number other mental illnesses, also accompanied by delirium. For example, the manic phase of bipolar affective disorder may result in psychosis accompanied by persecutory delusions.

In paranoid disorders, the personality disintegration characteristic of schizophrenia does not occur.

Thus, in the presence of paranoia, the diagnosis of schizophrenia will be made only if the patient has other symptoms.

Symptoms and signs

Most often, the first manifestations of the disease appear aged 20-25 years, in women a little later than in men.

This disease develops gradually. At the initial stage, which can last for several years, the patient experiences the appearance of obsessions and a distorted perception of his personality.

The person becomes anxious, suspicious, irritable may show aggression. These symptoms manifest themselves sporadically, so the disease often goes undetected at this stage.

Over time, the patient’s range of interests narrows, and it is difficult to interest him in anything.

It may also be observed decreased emotionality, which manifests itself in coldness and indifference to the problems of others.

Sometimes even the death of a loved one does not cause any emotions in a schizophrenic.

The patient may experience catatonic symptoms, expressed in excessive motor activity or, conversely, stupor. At the last stage of disease development delirium and hallucinations appear. The course of the disease becomes chronic.

Reasons

Paranoid schizophrenia occurs as a result of disturbances in the interaction between brain neurons, resulting in problems in transmitting and processing information.

At present, psychiatrists have not come to a clear conclusion about what factors lead to the development of schizophrenia in a patient.

According to research, a combination of several factors contributes to the appearance of this mental disorder:

Types of disease progression

There are several variants of the course of paranoid schizophrenia. The course of this disorder may be continuous and episodic. In turn, episodic is divided into a course with an increasing defect, with a stable defect and episodic remitting.

For continuous The course of schizophrenia is characterized by a gradual increase in the symptoms of a mental disorder and their subsequent constant severity over many years.

At episodic During the course of the disease, attacks alternate with periods of remission.

In the case of schizophrenia with a stable defect, the severity of symptoms remains at the same level from attack to attack, whereas with an increasing defect, negative symptoms constantly increase.

It's also possible episodic relapsing the course of paranoid schizophrenia, in which it is possible to bring the patient into a relatively stable remission.

Cognitive dissonance - what is it in simple words? find out right now.

Differential diagnosis

At the initial appearance of attacks of schizophrenia, a general medical diagnosis is necessary to exclude other diseases. To the patient an MRI is required, since some brain tumors can present with symptoms similar to schizophrenia.

A similar picture can also be observed with encephalitis, epilepsy, endocrine disorders and diseases of the central nervous system.

The doctor collects information about the behavioral characteristics of family members and possible mental diagnoses in relatives, since genetic predisposition plays a big role.

Among mental disorders, there are also a number of diseases that are similar in symptoms to schizophrenia (post-traumatic psychosis, schizoaffective disorder, substance abuse).

Therefore, to accurately diagnose schizophrenia, a psychiatrist needs long-term observation of the patient- from six months to a year.

And the basis for diagnosis will be the presence of several symptoms at once, which include hallucinations, paranoid delusions, incoherent speech, manifestations of autism, and emotional inadequacy.

Treatment methods

Acute attacks of paranoid schizophrenia require mandatory hospitalization and observation by a doctor in hospital.

Drug treatment consists of taking antipsychotics, which regulate the production of dopamine and serotonin. Traditionally, drugs such as haloperidol, tizercin, and aminazine were used.

New generation medications - clozapine, aripiprazole, rispolept and others.

Since schizophrenia is chronic, To prevent recurrent attacks, it is necessary to use a maintenance dose of drugs after discharge. In addition to drug treatment, psychotherapy sessions are conducted.

Forecast

Unfortunately, schizophrenia is currently completely curable impossible.

Paranoid schizophrenia can lead to serious personality changes and disability. However, in some cases it is possible to achieve long-term remission.

The prognosis of the disease is influenced by many factors. Hereditary schizophrenia more difficult to treat. The disease is usually more severe in men than in women.

If for the first time a mental disorder manifested itself in an acute rather than latent phase, and the patient was provided with timely psychiatric care, the chances of a favorable prognosis increase.

Paranoid schizophrenia in psychiatry: .

Although paranoid schizophrenia is severe form of mental disorder, methods of its treatment are constantly being improved and a good quality of life with properly selected treatment is quite achievable.

Paranoid schizophrenia - what is this diagnosis? Explanation in this video:

On social networks it is customary to call opponents “schizophrenics” and “paranoids”.
Since the terms are used purely as insults, like “fascist” or “liberal”, and gradually lose their meaning, the idea arose to streamline them somewhat.
Doctors don’t really know what schizophrenia is. Some even want to remove the term due to its complexity and ambiguity. Wiki chapter on this topic - .
The presence of this chapter almost completely invalidates the entire article.
But if you reduce schizophrenia to its simplest manifestations, it is quite possible to deal with it. As they say, it’s enough for our lifetime, and then the doctors will sort it out. Well, or they won’t figure it out...

Not schizophrenia
It’s better to start by repeating the famous phrase:

The presence of rationalization does not indicate schizophrenia. But schizophrenia and paranoia are always accompanied by rationalization. Behind this rationalization there may be either a disease or a lack of data, i.e. The problem may not be information processing, but a faulty premise.

Why thunder and lightning? Is Elijah the Prophet rolling or is there an electrical discharge?
If the error is not in the processing of information by the brain, but in the prerequisites, then this is not a disease.

The Wiki contains many signs. But all of them raise some doubts if we take them as determinants of diseases. In addition, many signs of schizophrenia and paranoia are present in descriptions of both diseases. This is not a defect of the Wiki article, it is precisely a defect of modern psychiatry.

For some reason, the Wiki doesn't list state hallucinations anywhere. This is, for example, when a person thinks that he is sick with something or will do something bad. One such hallucination of states is love. Love has signs that are most similar to a mental disorder, and can reach the level of a mental disorder - there is both an obsession and an inadequate perception of reality. For some it turns out to be even fatal. In some countries, in China for example, it is considered a serious but treatable mental illness. Most people know about the feeling of love, and this helps to understand what a crazy person feels. To imagine other states, you can remember love and put something else in its place. For example, fear is substituted for love, and Medvedev is substituted for an object. And all the other nonsense is the same.

There is often talk of “voices in the head” that give orders. But a person may know that these voices are a disorder of his psyche, and not pay attention to the voices. So “voices” can be identified as a separate disorder. "Voices", like other hallucinatory disorders, such as "radiation" ( ), may cause schizophrenia or paranoia, but may be perceived as symptoms of a disease and ignored.

Often there is talk about broken logic and loss of self-control. In the case of both diseases, these are not symptoms: logic may or may not work. Overt psychosis with loss of self-control may or may not exist.
There is often talk of a reduced emotional response. But this can happen to a completely healthy person. Although when other symptoms of schizophrenia or paranoia are observed, the emotional reaction does decrease. But the emotional reaction decreases during the disease, and not before.

Differences between schizophrenia and paranoia

If one obsession stands out, it is paranoia.
If it doesn’t stand out, it’s schizophrenia.

If the idea is one and simple, it’s paranoia.
If the idea is complex or there are many ideas, this is schizophrenia.

If you are being followed, this is paranoia.
If you are stalking someone, it is schizophrenia.

If they have a secret organization, that's paranoia.
If you have a super valuable idea, it’s schizophrenia.

If you pay a lot of attention to someone, this is paranoia.
If you don't get enough attention, it's schizophrenia.

If there are Napoleons all around, this is paranoia.
If you are Napoleon, this is schizophrenia.

If people around you look at you like you're shit, that's paranoia.
If you look at others like they're shit, that's schizophrenia.

But all these differences appear only in the early stages. As the illness progresses, the paranoid idea distorts the perception of the world, pulling it towards itself, as a result the world also becomes schizophrenic. And vice versa - schizophrenia leads to a distortion of the world, the consequent emergence of fears as a result of rationalization, and further to the emergence of paranoia.

Paranoia and schizophrenia in the process of development eventually become one and the same disease - paranoid schizophrenia. This, most likely, misleads psychiatrists.
Mentally ill people generally like to go out in large groups.

If you invented a perpetual motion machine, this is schizophrenia.
But if they want to steal your perpetual motion machine project, this is already paranoid schizophrenia.

If someone steals your toilet paper, that's paranoia.
If someone steals your toilet paper out of envy, this is already paranoid schizophrenia.

In the later stages of schizophrenia, a person often stops seeing the general and notices only the particular details of the general. Stops seeing the forest for the trees. The destruction of consciousness leads to the destruction of the picture of the world.
The cat turns into a set of parts – http://www.netlore.ru/Louis_Wain
This is where the love for cats ends.

Idiotic schizophrenia

A sign of idiotic schizophrenia is illogical nonsense. A person forgets what he just said or wrote. At the same time, rationalization works, and with its help a person reduces everything to a set of connections stuck in memory. From the outside it seems that the person is suffering from mild dementia.

“There are 70% crypto-Jews in Russia. They are rigging elections."
“The Jews know the real Truth about Eugenics, they zealously observe their racial hygiene - they do not mix with foreigners, and therefore they rule. They put their Jewish women under all the non-Jewish rulers..."
“Putin is ruining Russia. Putin, go away! Let's collect signatures for a letter to Putin so that he can help us..."

Idiotic schizophrenia can be reduced to poor memory, which does not allow one to constantly maintain an overall coherent picture of the world. As a result, its fragmentation occurs. But it should be noted that in civilization the world has become so complicated that most people were not designed for such complexity.

Idiotic schizophrenia has many degrees, depending on the state of memory. In mild forms, idiotic schizophrenia is very widely represented on social networks; There are very few people who allow contradictions in phrases, but very many allow contradictions in different posts, which is easy to notice.

Sometimes there are cases of idiotic schizophrenia in people who have achieved significant results in some areas of activity. These are intelligentots and geniots. This can be associated with the innate recombination of brain connections, when most of the connections is connected to one part of the brain, but there are not enough connections to other parts of the brain .

Idiotic schizophrenia usually does not progress.
Idiotic schizophrenia can be made as a diagnosis. But it must be remembered that the disorder does not arise on its own, but through interaction with a complex environment. If this man lived in a medieval village, his disorder would not be noticed and would not interfere with him or those around him. But in civilization there is too much data, and trying to process it leads to stress (similar stress occurs in those suffering from crowd phobia when they encounter them). Stress plus a lack of processing power in the brain adds up to idiotic schizophrenia.

A schizophrenic environment has developed in Russia. Moreover, a policy of further schizophrenia is being pursued through the media. This causes exacerbations in patients with any form of schizophrenia, but mainly people with idiotic schizophrenia are activated.

There are schizophrenics, schizophrenics, and schizophrenics. Kurginyan, for example, is a schizophrenic. By the way, he explains the process of schizophrenia well. He himself is not afraid of this, since his schizophrenics will still not be able to draw conclusions from his pure theory. Because they are idiotic.

Dismantling an individual (people) requires depriving the people of a single common goal (“idea”). “Eternal laughter” realizes this gap, the splitting of the “I”, that is, schizophrenia, the activation of its dark hypostasis and the suppression of the light. A disoriented consciousness needs a drug of consumption. Anyone who gets hooked on this needle becomes a “breakthrough.” (c) Kurginyan.

With the development of mass society, psychological management methods are replaced by psychiatric ones. And this is technologically true, since the quality decreases, and there are more and more sick people, so much so that they begin to play a significant and then decisive social role in the life of the community. Because they are above average active.

Illness is when problems arise. If there are reptilians from Nibiru, but there are no problems, this is not a disease. And if reptilians from Nibiru also sell well, then this is not a disease at all.

There is a popular opinion that “They go crazy alone, but together they only get sick with the flu”. For a healthy community this is true, but in a degenerative community there are a lot of people with idiotic schizophrenia who are prone to psychosis, so if there is a base - idiotic schizophrenia - psychosis can be transmitted. Psychosis, but not a disease. Previously, the “fear of Medvedev” was cited as an example, especially popular among supporters of the concept of the Kremlin being crazy. ( )

And one more moment. The most popular disorder in Russia is compensatory behavior based on the rationalization of one’s own inferiority. During compensatory behavior, a person can be very similar to a schizophrenic or paranoid because and distorts the world.

(E. Bleuler, TO. Kolle, W. Mayer-Gross etc.; a number of domestic authors) Let's move on to research in the second direction, when paranoia is considered among endogenous psychoses. Despite the similarity of views regarding the genesis of the disease, supporters of this trend adhere to different points of view regarding the nosological affiliation and the boundaries of paranoia. First of all you should to dwell on works that deny the independence of paranoia, and most of the cases originally attributed to E. Kraepelin to this disease is considered within the framework of atypical schizophrenia. The assumption about the unity of paranoia and schizophrenia was made by E. Bleuler back in 1911, and substantiated it in more detail in a later monograph “Affectivity, suggestibility and paranoia” (translated from German, 1929). Speaking of paranoia, E. Bleuler means an incurable disease with a “logically substantiated”, unshakable delusional system, built on the basis of the painful application to one’s personality of everything that happens in the environment; the disease is not accompanied by significant disturbances in thinking and affective life, and proceeds without hallucinations and subsequent dementia. The “stupidity” that occurs with paranoia should be distinguished from dementia. It rather resembles the state of people engaged in one-sided work, thinking and observing in one direction. The author attaches great importance in the development of paranoia to the structure of affect, the predominance of affect over logic. The affectiveness of paranoids has too great a switching force in relation to the strength of logical associations and at the same time is distinguished by its stability (as opposed to the lability of hysterics). Moving on to the question of the nosological independence of paranoia and its relationship with schizophrenia, the author distinguishes two aspects, and therefore two ways to solve this problem. Based on practical necessity, one should distinguish between the concepts of “paranoia” and “schizophrenia”. This follows from the following considerations. In cases of Kraepelinian paranoia, outside the delusional system there are no associative disorders and other gross anomalies and, above all, there is no dementia. Therefore, outside delirium there is, it would seem, no illness. This circumstance is practically significant in terms of determining the prognosis, since it indicates the possibility of an incomparably more favorable outcome in cases of paranoia compared to other delusional psychoses. If we define this disease from all other points of view (except for the assessment of the symptomatic picture and practical significance), that is, in a general theoretical aspect, then the given facts are not at all sufficient for judgments about the nosological independence of paranoia. On the contrary, it seems legitimate to interpret paranoia as a syndrome, which follows, according to E. Bleuler, considered within the framework of schizophrenia, and “very chronic schizophrenia”, which is “so mild” that it cannot yet lead to ridiculous delusional ideas. Other, less conspicuous symptoms are so little expressed that we are not able to prove their presence. “If the disease progresses, it leads to dementia, and the resulting dementia has a specific character.” But, as further emphasized by E. Bleuler, “The disease does not have to progress.” Thus, the development of the schizophrenic process can stop at any stage, as well. consequently, even when dementia is not yet noticeable. This is where E’s statement follows. Bleuler that the absence of dementia in paranoia cannot serve as a differential diagnostic sign to distinguish it from schizophrenia. At the same time, the unity of predisposition testifies to the relationship between paranoia and schizophrenia. Schizophrenia and paranoia seem to grow from the same root. A schizoid predisposition is a necessary precondition for the occurrence of both diseases. The differences boil down only to the degree of schizopathy and, therefore, already in this period are essentially quantitative and not qualitative. Future paranoids exhibit the same oddities as many potential “schizophrenics” and their relatives. The mechanism of delusion formation in paranoia is identical to that in schizophrenia. The schizophrenic process can cause weakness of associative connections, due to which even slightly increased affectivity has a pathogenic effect on the course of thinking, without leading to gross logical disorders of the latter. Therefore, concludes E. Bleuler, concept of schizophrenia intersectsWith the concept of paranoia, and some, albeit rare, observations in which we see only a picture of paranoia for a long time can still provide grounds for diagnosing the schizophrenic process (in this regard E. Bleuler also considers the “Wagner case” cited R. Gaupp). This qualification is most consistently adhered to by some supporters of the Heidelberg school, who continue the clinical traditions of E. Kraepelin, as well as psychiatrists who, when developing the problem of paranoia, follow the views of E. Bleuler. Qualification of paranoia as a symptomatic picture, which belonged to E. Bleuler, was reflected in a number of other studies(R. Kjambach, 1915; G. Eisath, 1915; O. Magenau, 1922). K. Kolle in his early works (1931) substantiates his position regarding the problem of paranoia, based on data from a follow-up examination of patients described earlier by E. Kraepelin, and own observations. These views were further developed in the author's later studies (1955, 1957). TO. Kolle denies paranoia as an independent disease. A small part of the observations, which E. Kraepelin at one time attributed to the group of psychogenies (delusions of querulants), is considered K- Kolle within the framework of psychopathy. In all other cases, in his opinion, we are talking about schizophrenia. In support of this point of view, K. Kolle gives the following arguments. The main symptom of the disease - delirium - in its nature, if we abstract from its psychological interpretation and approach it in terms of natural scientific consideration, is no psychopathologically different from that of schizophrenia. “Primaryity,” the psychological indeducibility of delusional formation, is the main criterion indicating the unity of paranoia and schizophrenia. The differences boil down to the fact that in cases classified as paranoia, delusion remains the only symptom throughout the entire course of the disease, while in schizophrenia, delusion precedes a number of other symptoms (hallucinations, autism, “personality disintegration,” etc.). Moreover, emphasizes K. Kolle, patients with isolated delirium, which retains from beginning to end the character of a closed, logically based system, are an exception, as indicated not only by clinical experience, but also by statistical data. Thus, among 30,000 patients studied at one time by E. Kraepelin, K. Kolle found only 19 such patients (but in 9 of them, in the future, allundoubted signs of schizophrenia were identified). Joche among 13,531 patients examined in 1953-1955, he noted only 8 similar patients. Thus, cases related to paranoia differ from schizophrenia only in the unique dynamics of the process, which is not in itself a nosological sign and may indicate, according to K.. Kolle, only about a special type of course of schizophrenia. On the other hand, the author cites a number of positive signs indicating possible reasons that determine the more favorable nature of the course of the disease in “paranoids” in contrast to “ordinary” patients with schizophrenia. To these reasons K- Kolle refers to a later age of onset of the disease, a pyknic and pyknic-athletic physique, the originality of the premorbid personality (the predominance of syntonic and cyclothymic subjects among “paranoids”, as well as sensitive and eccentric ones) and, finally, favorable (compared to the “classic” manifestations of dementia praecox) hereditary constellations. W. Mayer-Gross, classifying paranoia as delusional schizophrenia, in his report at the World Congress of Psychiatrists in Paris (1950) he emphasized that attempts to qualify paranoia as an independent disease were futile. At the same time, the author emphasizes that with the gradual development of the process, psychosis can cause paranoid behavior, which outwardly looks as if it is determined by the life situation. However, in these cases, there appears to be a subtle onset, accompanied by corresponding personality changes. Within these changes, the integration of paranoid behavior with surrounding circumstances occurs. This is where the “psychologically understandable” delusions of jealousy, sensitive delusions of relationship, etc. arise. E. Verbeck (1959) also considers paranoia as a variant of schizophrenia. At the same time, he especially emphasizes the role of predisposition, which, in his opinion, determines the uniqueness of the course of the disease. In cases of paranoia, we are talking about schizophrenia that occurs on a heteronomous basis - in persons with a hyperthymic predisposition. In this case, it is necessary to differentiate hyperthymics from cyclothymics. Cyclothymics include people whose basic affective predisposition is unstable and their mood alternates between depressed and cheerful. Hyperthymic people are characterized by constant lively affect, they are characterized by activity, greater ability to work, expansiveness, good adaptability, and high spirits. It is hyperthymic people who are found in families of so-called paranoids. On the other hand, hyperthymic predisposition is rare in patients with schizophrenia. According to E. Verbeck, hyperthymic predisposition and has protective functions. Therefore, with such a constitution, the schizophrenic process does not manifest itself immediately, and if the personality nevertheless “attacks,” then the disease, one must assume, will proceed unnoticed, without obvious disturbances. R. Lemke (1951, 1960), like K. Kolle, is inclined to classify paranoia as paraphrenia, and consider the latter in the group of schizophrenia along with the paranoid form, hebephrenia and catatonia. It should be emphasized that a number of domestic authors consider chronic delusional psychoses, related to paranoia, within the framework of schizophrenia. V. I. Finkelstein (1934) and K. A. Novlyanskaya (1937) described low-progressive paranoid psychoses, the initial manifestations of which seemed to correspond to “shifts” of individual characterological characteristics of the personality, but later a transformation of these symptoms into corresponding super-valuable formations was observed. The authors associate the uniqueness of psychopathological symptoms and the development of the disease with a sluggish schizophrenic process. A. 3. Rosenberg (1939) opposes the nosological independence of one of the varieties of chronic delusional psychoses - involutional paranoia. He comes to the conclusion that there is no special involutionary delusional psychosis, and most of the observations considered by K- Kleis t (1913) and some other Psychiatrists (P. Seelert, 1915; A. Serko, 1919) within the framework of involutional paranoia, or paraphrenia, as independent diseases, should be classified as late schizophrenia. As A. Z. Rosenberg emphasizes, in a number of cases of late delusional psychoses, it is possible to detect a breakdown in the anamnesis, which was sometimes not accompanied by profound changes in the life line of the individual, but marks the beginning of new trends, outwardly manifested in the gradual withdrawal of the patient from society. It is these changes that occur as a result of schizophrenia, and not some special process characteristic of paranoia, which supposedly contributes to the development of tendencies inherent in a healthy personality, that re-create the preconditions for the formation of delusions. A. I. Molochek (1944), studying the final states of schizophrenia, showed that it is the observation of the outcome of psychoses (and not their debut) that makes it possible to deprive a number of chronic delusional diseases of nosological independence. At the same time, A.I. Molochek notes that a thorough follow-up study of patients who were diagnosed with paranoia indicates that this diagnosis seemed justified only up to a certain stage in the development of the disease; subsequent observations indicated that the entire symptom complex belongs to schizophrenia. The peculiarity of the course of such forms is explained by the fact that the development of paranoid schizophrenia, like all other biological processes, does not follow only one path - a linear continuous decay leading to schizophrenic dementia; Another path is also possible - towards further transformation of the constitutional paranoid foundations of the individual. In accordance with this, the author describes as one of the options for the course of schizophrenia the development of a process with gradually increasing affective and volitional changes in personality and an intellectual defect (a consolidated type of defective state); it is also possible in the future to systematize delirium, even in the final state not subject to disintegration. The development of delusions occurs in such cases, starting, it would seem, from real motives, situational and reactive exacerbations, to a closed, fixed, autistic delusion, gradually losing its dependence on the outside world. G. N. Sotsevich (1955) distinguishes among patients with paranoid schizophrenia a group in which systematized delusions were observed throughout the entire course of the disease, and the clinical picture and course here largely corresponded to the descriptions of psychoses known V literature called paranoia. As signs indicating the validity of diagnosing schizophrenia in such cases, G. N. Sotsevich points to mental decline, characterized by progressive emotional devastation, a gradual decline in working ability and, finally, a persistent disorder of thinking in the form of unproductivity, thoroughness, and viscosity. G. A. Rothsheitn (1961) directly identifies hypochondriacal paranoia of the prenosological period with paranoid schizophrenia. At the same time, he, like G.N. Sotsevich, speaks of schizophrenia not only when, after a long period of many years, determined by systematized hypochondriacal delusions, hypochondriacal paranoia is replaced by hypochondriacal paraphrenia (i.e., the paranoid stage of the development of the disease is replaced by paranoid and paraphrenic). Within the framework of schizophrenia, he also considers cases with a more favorable course, where paranoid disorders persist for decades, and sometimes throughout life. The emergence of a monothematic hypochondriacal idea is often associated with some minor somatic phenomenon, after which the patient develops a delusional belief in the presence of some serious illness (syphilis, cancer, etc.). Over time, the intensity of delirium decreases, but hypochondriacal ideas do not disappear and are not corrected. Chronically occurring paranoid states with delusions of interpretation, not accompanied by deceptions of perception, are described within the framework of schizophrenia by a number of other authors (N. G. Romanova, 1964; L. M. Shmaonova, 1965-1968; E. G. Zhislina, 1966; L. D. Gissen, 1965). Thus, L. M. Shmaonova identifies among patients with indolent schizophrenia a group with a predominance of paranoid disorders; due to the favorable nature of the process, despite the age of the disease, most of these patients were in the hospital no more than 1-2 times, and others - not even once. The author emphasizes that often in such cases the diagnosis at the initial stages of the disease did not go beyond borderline conditions . Only later were personality changes that were initially subtle (lethargy, isolation, monotony, decreased interests and initiative) revealed, indicating the presence of a sluggish schizophrenic process. The well-known social and even professional adaptation observed in these patients does not contradict this diagnosis, since a slow, sluggish progression allows compensatory capabilities to best manifest themselves.