Affective symptoms and emerging psychotic disorder in adolescents

Abstract

Depressive symptoms are frequently reported during the period preceding the onset of schizophrenia in adolescents when such symptoms can be mistaken for those of mood disorder. However, it is unclear which emotional symptoms should be considered predictive of schizophrenia onset.

The types of emotional disturbances that may precede schizophrenic disorder were sought through a review of historical descriptive studies and seminal works using a phenomenological approach. Five main types of emotional disturbances have been found as prodromal symptoms of a schizophrenic disorder: (1) increased sensitivity to stress, (2) poor or incomplete expression of emotions, (3) reduced emotion sharing, (4) emotional detachment, and (5) disconnection between the perception and expression of emotions. Studies based on phenomenological views of schizophrenic disorders stressed the chronological sequence of these symptoms in the same person. For example, the term “delusional mood” (Wahnstimmung) coined to describe changes in the perceived atmosphere encompass mood disturbances from subtle emotional overreactivity to more severe symptoms that could evoke athymhormia.

Analysis of recent studies among subjects at high-risk for psychotic transition showed that the presence of mood symptoms at a very early stage of the disorder is common. While these symptoms predict a lower level of general functioning, they were not associated with a higher risk of developing a schizophrenic disorder at follow-up.

Disclosure of interest

The authors have not supplied their declaration of competing interest.