Prodromal Symptoms in Schizophrenia
Prodromal symptoms are those that occur in the prodrome phase of schizophrenia, a period that occurs one to two years before psychotic symptoms emerge. Two of the most commonly reported symptoms of this period are social withdrawal and changes in behavior at school or work. These symptoms are often not recognized as schizophrenia, which can make early detection of the disorder difficult.
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Subgroups
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There are three subgroups of prodromal symptoms: attenuated positive symptom syndrome (APSS), brief intermittent psychotic syndrome (BIPS) and genetic risk plus functional deterioration (G/D).
Attenuated positive symptom syndrome
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Symptoms in this subgroup include distorted perceptions, communication problems and strange or unusual thoughts. These symptoms should occur at least once a week for a period of one month or longer. Symptoms should continually get worse over time.
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Brief intermittent psychotic syndrome
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Symptoms of this subgroup include intermittent psychotic thoughts or hallucinations in addition to perception and communication problems. These symptoms should occur once a day for one to three months.
Genetic risk plus functional deterioration
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People with symptoms of this subgroup will have previously been diagnosed with a schizotypal personality disorder or have a first-degree relative who has been diagnosed with schizophrenia or a personality disorder with psychotic symptoms. Other symptoms include decline in school or work performance, overall decrease in daily functioning, social withdrawal and unusual behavior.
Considerations
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The prodromal stage of schizophrenia is marked by changes in perception, social withdrawal and changes in effort and attendance at work or school. Because these prodromal symptoms can mimic those of other psychiatric problems, many patients are often misdiagnosed at this point in the disorder. The true problem is often not discovered until symptoms finally do meet the criteria for schizophrenia.
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