THE VULNERABILITY STRESS MODEL OF SCHIZOPHRENIC RELAPSE - A LONGITUDINAL-STUDY/

A tentative model for conceptualizing the interplay of vulnerability f actors, stressors, and protective factors in the course of schizophren ia is discussed. A study of the initial years after a first schizophre nic episode is testing the predictive role of key factors. During an i nitial 1-year period of depot antipsychotic medication, independent li fe events and expressed emotion were found to predict the likelihood o f psychotic relapse. Initial analyses indicate that independent life e vents play less of a role in relapse prediction during a medication-fr ee period. These results suggest that maintenance antipsychotic medica tion raises the threshold for return of psychotic symptoms, such that relapses are less likely unless major environmental stressors occur. A low expressed emotion environment may be a protective factor.