It is appropriate to divide the description of exacerbation of schizophrenia into two subtopics:   

1. The first psychotic episode, the deployment of which often begins treatment and is first diagnosed.  
2. Exacerbations (relapses) of an already diagnosed disease.

It cannot be argued that the first acute psychosis in schizophrenia always comes suddenly and out of nowhere. Often, the symptoms of schizophrenia manifest themselves with varying degrees of severity in the prodromal (previous illness) period. They are not always recognized as signs of schizophrenia, and therefore, most often, relatives of the sick person seek help at the moment when the condition becomes acute. Although, as Eugen Bleuler rightly noted at the beginning of the last century, tracing the history of the development of the disease of the first admitted patient, one can almost always find in it a mild symptomatology of schizophrenia. This is the so-called negative symptomatology. In comparison with delusions and hallucinations, which quickly attracted the attention, negative symptoms are less visible, but more dangerous and much worse treatment                      

In the first acute episode of schizophrenia, it can be very difficult to predict the prognosis of the course of the disease. However, the entire further prognosis of the disease depends on the quality of timely assistance. As a rule, the duration of the acute phase of schizophrenia lasts 6-8 weeks.   

Signs of the acute phase of schizophrenia:

• strange, incomprehensible human behavior;
• delirium, hallucinations (more often auditory), 
• the patient can “hear voices”: as a rule, they first comment on his actions and on the extent of the disease and exacerbation of schizophrenia may become more aggressive and begin to order, manage, man;    
• the patient can feel someone’s influence on his own thoughts; 
• irritability, isolation appears,
• trying to understand what is happening to him, a person plunges into the world of inner experiences;   
• there is a feeling of confusion and helplessness. 

Not in spite of what some experts say about the possibility of knocking over the first psychotic episode with schizophrenia at home, we insist, given the significance (as a thorough diagnostic evaluation and a full course of treatment), on the need of the patient rooms in the hospital.        

Acute psychosis is incredibly difficult and often dangerous to stop and treat at home. Often, the patient’s condition can pose a threat to both himself and the people around him. Only a full-fledged treatment in a hospital can give a positive, sustainable result.      

It is noted that every fifth patient does not experience an exacerbation of schizophrenia after the first episode in later life . Between the first and second episodes, the manifestations of the disease may not be very noticeable. Only a small percentage of people with schizophrenia have symptoms of schizophrenia over the years.       

Recurrence of schizophrenia occurs in 20% of patients, even with treatment. In case , if the treatment is not assigned, then the likelihood of recurrence of recurrence is 70%.       

The first signs of relapse

Timely treatment of acute attacks of schizophrenia is very important for the further prognosis of the disease. Timely relief of an incipient attack is also very important, since each subsequent case of exacerbation, alas, is more severe than the previous one, is longer and can aggravate the patient’s condition.  

At the first signs of exacerbation of schizophrenia, it is necessary to provide the patient with high-quality and immediate medical care. In the event that the patient’s condition is difficult to control, and self-get to hospital he did not perhaps need to immediately call the emergency psychiatric care.