Prodromal symptoms and prevention of relapse in schizophrenia

There has been little systematic study of early signs of relapse in schizophrenia. Determination of a prodromal symptom profile could facilitate early intervention before the development of a full-blown episode. A structured questionnaire was used to assess prodromal symptoms in two samples of schizophrenic patients, one of which included family informants. The symptoms most frequently mentioned as appearing or worsening before psychotic episodes were tenseness/nervousness, decreased appetite, trouble concentrating, difficulty sleeping, depression, and social withdrawal. Subsequent prospective studies by others have generally verified the existence of these dysphoric affective symptoms prior to full relapse. The treatment implications of these nonpsychotic affective symptoms in the prodromal phase are outlined.