Initial prodrome description in recent onset schizophrenia

ABSTRACT

Initial prodromal phase is gaining increasing significance for early detection, management and prognosis of recent onset psychosis. The present work aimed to assess and describe the prodromal phase in subjects with recent onset schizophrenia. 43 cases of recent onset schizophrenia were collected on outpatient basis and diagnosed according to ICD-10 DRC [WHO, 1993]. A prodrome questionnaire to subject and informant was used to assess prodromal phase retrospectively. Results showed that 30 cases [69.9%] had prodrome reported either by subject only [3 cases 7%], informant only [13 cases 30.2%] or by both subject and informant [14 cases, 32.6%]. The duration of the prodrome reported by subjects ranged from 30- 1825 days [5 years] [mean = 475.6 days, SD = +/- 495.1]. The duration of the prodrome reported by informants ranged from 30- 1095 days [3 years] [mean =361.1 days, SD = +/- 356.7]. Prodromal symptoms, most commonly reported by subjects, were Suspiciousness and Social withdrawal, followed by Ideas of references and Insomnia. Prodromal symptoms, most commonly reported by informants, were Social withdrawal, Impaired functioning, followed by Somatic symptoms, Anxiety and Decreased appetite. Recent onset schizophrenic patients experienced an initial prodromal phase that may vary from weeks to many years in duration. Prodrome can present with negative prodromal signs, positive symptoms and/or non-specific symptoms. The more prolonged prodromes are associated with more insidious onset and more impairment of functioning