How can you recognize relapse in a patient with schizophrenia?

• A. Return of prominent positive symptoms (delusions, hallucinations) or deterioration in functioning.
• B. Stable mood and improved functioning.
• C. Weight gain and improved appetite.
• D. Decrease in sleep only.

Answer: (A)

Relapse in schizophrenia is signaled by a return or worsening of active psychotic symptoms along with a decline in daily functioning. When a person who had Freund remission experiences delusions or hallucinations again, or their ability to manage work, self-care, and social relationships deteriorates, that’s a clear indication that the illness has become active again. These positive symptoms reflect disease activity and functional impact, which is why this option best captures relapse.

Stable mood and improved functioning show ongoing stability, not relapse. Weight gain with better appetite isn’t related to a resurgence of psychosis. A decrease in sleep by itself is nonspecific; sleep changes can occur for many reasons and don’t define relapse unless accompanied by a reemergence of psychotic symptoms or a noticeable drop in functioning.