Acute schizophrenia isn’t short-duration schizophrenia that goes away after a few weeks. It’s an experience during the progression of schizophrenia, where symptom intensity increases.
Schizophrenia is a lifelong mental health disorder involving symptoms of altered reality perception, cognitive impairment, and losses in function, referred to as “negative symptoms.”
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) classifies schizophrenia as a psychotic disorder. The main characteristics of the disorder include:
- Hallucinations: false sensory perceptions
- Delusions: incorrect, rigid beliefs despite evidence to the contrary
- Disorganized thinking (also known as disorganized speech): incoherence or thought derailment
- Severely disorganized movement: Unpredictable agitation or catatonia
- Negative symptoms: Alogia (speech difficulty), decreased emotional expression, anhedonia, avolition (lack of motivation), asociality
Many people receive a diagnosis during acute schizophrenia, which is a period of time when symptoms become more noticeable.
Acute schizophrenia is a period of time when symptoms intensify or worsen. It’s not a formal diagnostic term but provides a way for doctors to add clarity and specificity to your current personal experience of schizophrenia.
Acute schizophrenia and staging models
The term “acute schizophrenia” is often used interchangeably with “active schizophrenia”, but the two aren’t always the same.
The active phase of schizophrenia is a formal phase of schizophrenia that happens after the prodromal phase. The prodromal phase is the initial period of time when symptoms emerge and are less obvious.
The DSM-5-TR recognizes the active phase as a part of the physiological progression of schizophrenia. This phase is when symptoms are clearly defined and actively causing impairment.
Traditional staging models often limit schizophrenia to just the prodromal and active phases, which is why the active phase is often referred to as the acute phase.
Many different staging models exist in scientific literature, with some having as many as 8 stages. For this reason, acute schizophrenia can also describe any period of time in schizophrenia when core symptoms worsen.
While symptoms naturally become more obvious during the active phase, they may also increase in intensity during the recovery, residual, or chronic phases identified in other models.
Chronic vs. acute schizophrenia
The term “acute” in medical terminology often describes conditions that have a sudden, severe onset and short duration. The opposite of acute is “chronic,” a term usually describing long-term conditions with persistent symptoms.
Acute schizophrenia is not short-duration schizophrenia, however. In many long-term disorders with fluctuating symptoms, “acute” can describe a period of intensity within the disorder.
Acute schizophrenia is a presentation of symptoms within a formal schizophrenia diagnosis. You may experience a worsening of any symptoms seen in schizophrenia.
Positive symptoms in schizophrenia are those that add experiences to your typical level of function. They include:
Negative symptoms indicate a loss of typical behaviors across five areas:
- Alogia: decreased speech
- Anhedonia: difficulty experiencing pleasure
- Avolition: lowered motivation and activity
- Asociality: social withdrawal
- Diminished emotional expression: also known as “flat affect”
According to the DSM-5-TR, reduced emotional expression and avolition are the main negative symptoms of schizophrenia.
For some people, acute schizophrenia may involve worsening cognitive symptoms, such as major difficulties with:
- focus and attention
- social interaction
The exact causes of schizophrenia aren’t clear, but experts believe genetics, brain chemistry, the environment, and lifestyle factors all play a role.
Most people experience the active phase of schizophrenia in early adulthood. However, symptoms can become acute as schizophrenia progresses for a number of reasons.
You may experience acute, or worsening, symptoms if you:
- have just entered the active phase of schizophrenia from the prodromal phase
- stop or don’t seek schizophrenia treatment
- don’t take medications as directed
- use drugs or alcohol
- develop poor sleep habits
- also experience a mental health disorder, like depression
- have a stressful life event, like a job loss
- have a loss in your support system
Acute schizophrenia is not a diagnosis on its own. Schizophrenia is the diagnosis, and acute schizophrenia is a symptom presentation within it.
According to the DSM-5-TR, doctors diagnose schizophrenia if you’ve been experiencing two or more symptoms of:
- disorganized thinking/speaking
- disorganized motor function
- negative symptoms
Overall, continuous signs of schizophrenia must be present for 6 months or longer. For at least 1 month during that time, symptoms must occur regularly. Symptoms must include hallucinations, delusions, or disorganized thinking.
Your mental health professional will also consider the level of difficulty you experience across major areas of your life, such as work, self-care, and relationships.
Once you’ve received a schizophrenia diagnosis, your doctor will regularly monitor you for episodes of acute schizophrenia. Experiencing an increase in symptoms may indicate it’s time to adjust medications or therapy approaches.
There’s no cure for schizophrenia, but research suggests as many as 60% of people will have symptom remission with treatment.
Doctors treat schizophrenia using a dynamic approach of psychotherapy, medications, and psychosocial support. Acute symptoms can be managed by making changes to your current treatment regimen.
Psychotherapy is also known as talk therapy because it involves guided sessions where you discuss your experiences with schizophrenia with a mental health professional.
Common psychotherapy approaches to treat schizophrenia include:
- cognitive behavioral therapy (CBT)
- cognitive behavioral therapy for psychosis
- family therapy
- compliance therapy
- acceptance and commitment therapy
- personal therapy
- cognitive enhancement therapy
Your therapist may take a multidimensional approach, combining parts of multiple therapy frameworks to give you individualized care.
Doctors treat schizophrenia with a variety of antipsychotic medications to help relieve symptoms like hallucinations and delusions. Your doctor may also prescribe medications to help manage co-occurring symptoms like anxiety and depression.
As a lifelong condition, schizophrenia can cause significant difficulties across multiple areas of daily activities. Psychosocial supports are there to help you maintain your ability to work, learn, care for yourself, and participate in your community.
Examples of psychosocial supports include:
- family and individual psychoeducation about schizophrenia
- assertive community treatment programs to connect with relevant services
- peer groups and support networks
- individualized case management
- housing assistance
- social skills training
The term “acute schizophrenia” is sometimes used interchangeably with “the active phase of schizophrenia.” However, these terms can describe different experiences.
The active phase of schizophrenia is a formal part of schizophrenia’s physiological progression. Acute schizophrenia is a time period when symptoms worsen anywhere within that progression.
Schizophrenia, including acute schizophrenia, can be treated with psychotherapy, medication, and psychosocial support efforts.