Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-10T03:12:55.987Z Has data issue: false hasContentIssue false
  • English
  • Français

Prodromal Symptoms in Schizophrenia

Published online by Cambridge University Press:  02 January 2018

Ashok K. Malla  and
Ross M. G. Norman
Ashok K. Malla*
Affiliation:
Department of Psychiatry, University of Western Ontario and Chief of Psychiatry, Victoria Hospital, 375 South Street, London, Ontario, N6A 4G5, Canada
Ross M. G. Norman
Affiliation:
Department of Psychiatry, University of Western Ontario
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper describes a prospective study of the relationship between non-psychotic prodromal symptoms and psychotic symptoms in 55 schizophrenic (DSM–III–R) out-patients. Once a month, a number of non-psychotic symptoms generally regarded as prodromal symptoms in schizophrenia were assessed, as well as psychotic symptoms, with standardised self-administered instruments and rating scales for a minimum of 12 months (range 12–29). The data were analysed for each patient using a longitudinal correlational design with a 1-month lag between the prodromal and psychotic symptoms over the total period. Results showed that in less than one-fifth of subjects did any of the prodromal symptoms, individually or in combination, show a significantly positive correlation with the subsequent level of psychotic symptoms. Such relationships were significant in an even smaller proportion of subjects when the confounding effect of concurrent psychotic symptoms on prodromal symptoms was partialled out. High levels of prodromal symptoms appeared to have adequate specificity but low sensitivity in their power to predict high levels of subsequent psychotic symptoms. There were no differences in age, gender, medication levels, and the number of previous admissions between the subjects who did or did not show a relationship between putative prodromal symptoms and psychotic symptoms.

Type
Papers
Information
The British Journal of Psychiatry , Volume 164 , Issue 4 , April 1994 , pp. 487 - 493
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, N. C. (1983) The Scale for Assessment of Negative Symptoms (SANS). Iowa City, Iowa: The University of Iowa.Google Scholar
Andreasen, N. C. (1984) The Scale for Assessment of Positive Symptoms (SAPS). Iowa City, Iowa: The University of Iowa.Google Scholar
Arndt, S., Alliger, R. J. & Andreasen, N. (1991) The distinction of positive and negative symptoms: the failure of a two dimensional model. British Journal of Psychiatry, 158, 317–322.CrossRefGoogle ScholarPubMed
Barnes, T. R., Curson, D. A., Liddle, P. F., et al (1989) The nature and prevalence of depression in chronic schizophrenic inpatients. British Journal of Psychiatry, 154, 486–491.Google Scholar
Bartels, S. J. & Drake, R. E. (1988) Depressive symptoms in schizophrenia: comprehensive differential diagnosis. Comprehensive Psychiatry, 29, 467–483.Google Scholar
Beck, A. T. (1978) Beck Depression Inventory. New York: Harcourt Brace Jovanovich.Google Scholar
Birchwood, M., Smith, J., MacMillan, F., et al (1989) Predicting relapse in schizophrenia: the development and implementation of an early signs monitoring system using patients and families as observers, a preliminary investigation. Psychological Medicine, 19, 649–656.Google Scholar
Carpenter, W. T. & Heinrichs, D. W. (1983) Early intervention, limited, targeted pharmacotherapy of schizophrenia. Schizophrenia Bulletin, 9, 533–542.Google Scholar
Cohen, S., Kamarck, T. & Mermelstein, R. (1983) A global measure of perceived stress. Journal of Health and Social Behaviour, 24, 385–396.Google Scholar
DeLisi, L. E., Crow, T. J. & Hirsch, S. R. (1986) The Third Biannual Winter Workshop on Schizophrenia. Archives of General Psychiatry, 43, 706–711.Google Scholar
Docherty, J. P., Van Kammen, D. P., Siris, S. G. & Marder, S. R. (1978) Stages of onset of schizophrenic psychosis. American Journal of Psychiatry, 135, 420–426.Google ScholarPubMed
Falloon, I. R. H. (1984) Relapse: A reappraisal of assessment of outcome in schizophrenia. Schizophrenia Bulletin, 10, 293–299.CrossRefGoogle ScholarPubMed
Foulds, G. & Bedford, A. (1975) Hierarchy of classes of personal illness. Psychological Medicine, 5, 181–192.Google Scholar
Foulds, G. (1976) The Hierarchical Nature of Personal Illness. London: Academic Press.Google Scholar
Goldberg, D. (1978) Manual of the General Health Questionnaire. Windsor: NFER/Nelson.Google Scholar
Heinrichs, D. W. & Carpenter, W. T. (1985) Prospective study of prodromal symptoms in schizophrenic relapse. American Journal of Psychiatry, 142, 371–373.Google Scholar
Herz, M. (1985) Prodromal symptoms and the prevention of relapse in schizophrenia. Journal of Clinical Psychiatry, 46, 22–25.Google ScholarPubMed
Herz, M. & Melville, C. (1980) Relapse in schizophrenia. American Journal of Psychiatry, 137, 801–805.Google Scholar
Herz, M., Szymanski, H. V. & Simon, J. C. (1982) Intermittent medication for stable schizophrenic outpatients: an alternative of maintenance medication. American Journal of Psychiatry, 139, 918–922.Google Scholar
Herz, M., & Simon, J. C. (1986) Prodromal signs of schizophrenia relapse Getter). American Journal of Psychiatry, 143, 115–116.Google Scholar
Herz, M., Glazer, W., Mirza, M., et al (1989) Treating prodromal episodes to prevent relapse in schizophrenia. British Journal of Psychiatry, 155 (suppl. 5), 123–127.CrossRefGoogle Scholar
Herz, M., Glazer, W. M., Mostert, M. A., et al (1991) Intermittent vs. maintenance medication in schizophrenia. Archives of General Psychiatry, 48, 333–339.CrossRefGoogle ScholarPubMed
Hirsch, S. R. & Jolley, A. G. (1989) The dysphoric syndrome in schizophrenia and its implications for relapse. British Journal of Psychiatry, 155 (suppl. 5), 46–50.Google Scholar
Hirsch, S. R. & Jolley, A. G., Barnes, T. R. E., et al (1989) Dysphoric and depressive symptoms in chronic schizophrenia. Schizophrenia Research, 2, 259–264 Google Scholar
Holtzman, W. H. (1963) Statistical models for the study of change in the single case. In Problems in Measuring Change (ed. Harris, C. W.). Madison: University of Wisconsin Press.Google Scholar
Huber, G. & Gross, G. (1989) The concept of basic symptoms in schizophrenia and schizoaffective psychoses. Recenti Progressi in Medicini, 80, 646–652.Google ScholarPubMed
Jolley, A. G., Hirsch, S. R., McRink, A., et al (1989) Trial of brief intermittent prophylaxis for selected schizophrenic outpatients: clinical outcome at one year. British Medical Journal, 298, 985–990.CrossRefGoogle ScholarPubMed
Jolley, A. G., Hirsch, S. R., Morrison, E., et al (1990) Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenic outpatients: clinical and social outcome at two years. British Medical Journal, 301, 837–842.Google Scholar
Kulhara, P., Kota, S. K. & Joseph, S. (1986) Positive and negative subtypes of schizophrenia: A study from India. Acta Psychiatrica Scandinavica, 74, 353–359.Google Scholar
Kumar, S., Thara, R. & Rajkumar, S. (1989) Coping with symptoms of relapse in schizophrenia. European Archives of Psychiatry and Neurological Science, 239, 213–215.Google Scholar
Liddle, P. F. (1987) The symptoms of chronic schizophrenia: a re-examination of the positive-negative dichotomy. British Journal of Psychiatry, 151, 145–151.CrossRefGoogle ScholarPubMed
Liddle, P. F. & Barnes, T. R. (1990) Syndromes of chronic schizophrenia. British Journal of Psychiatry, 157, 558–561.Google Scholar
Lukoff, D., Liberman, R. P. & Nuechterlein, K. H. (1986) Symptom monitoring in the rehabilitation of schizophrenic patients. Schizophrenia Bulletin, 12, 578–602.CrossRefGoogle ScholarPubMed
Malla, A., Norman, R. M. G., Williamson, P., et al (1993) Three syndrome concept of schizophrenia: a factor analytic study. Schizophrenia Research, 10, 143–150.Google Scholar
Marder, S. R., Van Putten, T., Mintz, J., et al (1984) Maintenance therapy in schizophrenia: New findings. In Drug Maintenance Strategies in Schizophrenia (ed. Kane, J. M.). Washington, DC: American Psychiatric Association.Google Scholar
Norman, R. M. G. & Malla, A. K. (1991a) Dysphoric mood and symptomatology in schizophrenia. Psychological Medicine, 21, 897–903.CrossRefGoogle ScholarPubMed
Norman, R. M. G. & Malla, A. K. (1991b) Subjective stress in schizophrenic patients. Social Psychiatry and Psychiatric Epidemiology, 26, 212–216.Google Scholar
Siris, S. G., Adan, F., Cohen, M., et al (1988) Post psychotic depression and negative symptoms: An investigation of syndromal overlap. American Journal of Psychiatry, 145, 1532–1537.Google Scholar
Spielberger, C. D., Gorsuch, R. L. & Lushene, R. (1968) Self-Evaluation Questionnaire. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Spitzer, R. L. & Williams, J. B. W. (1985) Structured Clinical Interview for DSM–III–R - Patient Version (SCID-P), 7/1/85. New York: New York State Psychiatric Institute, Biometrics Research Department.Google Scholar
Subotnik, K. L. & Nuechterlein, K. H. (1988) Prodromal signs and symptoms of schizophrenic relapse. Journal of Abnormal Psychology, 97, 405–412.Google Scholar
Tarrier, N., Barrowclough, C. & Bamrah, J. S. (1991) Prodromal signs of relapse in schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 26, 157–161.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.