Stages of Schizophrenic Decompensation and Reintegration

As part of a rater blind outpatient drug study, 27 chronic schizophrenic patients experienced acute psychotic decompensation when removed from active medication. On close clinical observation, it was discovered that the patients passed through four distinct phenomenological stages during decompensation. During reintegration on active medication, the patients passed through the same stages, but in reverse order. Recognition of these stages is important clinically because it increases our understanding of the patient’s dynamics, serves as a model for the natural histories of the schizophrenias, and offers guidelines for psychotherapy and the administration of antipsychotic medication.