Residual schizophrenia is diagnosed when a person has a history of prominent schizophrenic symptoms, but none of his/her current symptoms dominate the clinical presentation. In other words, s/he may still be experiencing delusions, hearing voices, or showing some signs of disorganized speech or other positive symptoms typical of schizophrenia, but the intensity has decreased significantly. The symptoms are no longer as severe as they were when s/he was acutely ill, but indicators of the disorder are still evident.
Instead, the person may only be exhibiting some degree of odd behavior, or his/her speech may be only mildly disorganized. S/he may also have some strange beliefs. With residual schizophrenia, if hallucinations or delusions are still part of the picture, the person doesn’t have any strong emotions associated with them.
In this type of schizophrenia, some of the negative symptoms of schizophrenia are still present. For example, s/he may still have blunted emotions, have difficulties initiating or carrying out tasks or show signs of impaired thought processes.
Additional Diagnostic Criteria
In order to meet the diagnosis of schizophrenia, regardless of the type, these other criteria must also have been met prior to the diagnosis of residual schizophrenia:
- A marked decline in functioning, after the onset of symptoms, in at least one of the primary aspects of the person’s life (e.g., work, school, relationships, self-care).
- Signs of the disorder are present continuously for a period of at least 6 months. For at least one month of that time period (less if they subside due to effective treatment), the active-phase symptoms (e.g. delusions, hallucinations, extremely disorganized behavior, etc.) must be present.
- Schizoaffective disorder (a disorder similar to schizophrenia but with prominent mood episodes) or other mood disorder must have been ruled out.
With the residual type of schizophrenia, it may be a transitional period which is occurring between an acute episode and a full remission. In some cases, however, the person may continue to meet the criteria for the residual type for a very long time, even years.
written by Dr. Cheryl Lane, PsyD
