ASSESSMENT OF PRODROMAL SIGNS AND SYMPTOM S TO PREVENT RELAPSE IN SCHIZOPHRENIA

In the treatment of schizophrenia, two new strategies have been develo ped with the aim of adequate relapse prevention accompanied by lowest possible risk of side-effects. One strategy is to have the patient con tinue to take medication at a highly reduced dosage (10-20% of the sta ndard dose). The other is to gradually stop neuroleptic medication aft er remission and to reinstitute medication only in the case of prodrom al symptoms (termed targeted or intermittent treatment). According to Herz and Melville [13] many schizophrenic patients show signs of relap se well before recurrence of overt psychotic features. Monitoring to d etect prodromal symptoms is especially important in targeted treatment because, otherwise, neuroleptic medication often cannot be initiated in time. In the present study of 51 schizophrenic patients we were abl e to replicate the results of Herz & Melville in the German-speaking c ountries. Prior to acute exacerbation of psychosis, most patients expe rience alterations of feelings and behaviour. These alterations may al so be recognized by family members. Such early warning signs of relaps e mainly consist of non-specific, non-psychotic symptoms: tenseness an d nervousness, eating less, trouble concentrating and sleeping, depres sive mood and seeing friends less. Furthermore, the regular monitoring and use of early warning signs specific to each patient in the afterc are of schizophrenic patients seems to be practicable, especially in p sychoeducative family therapy.