SELF-EXPERIENCED VULNERABILITY - PRODROMAL SYMPTOMS AND COPING STRATEGIES PRECEDING SCHIZOPHRENIC AND AFFECTIVE EPISODES

For the first time, the present study explores self-experienced vulner ability, prodromal symptoms and coping strategies preceding schizophre nic and affective episodes. 33 schizophrenic and 29 depressive patient s were assessed retrospectively for preepisodic alterations by means o f the ''Bonn Scale for the Assessment of Basic Symptoms - BSABS'' afte r complete recovery from the acute episode. 97 % of the schizophrenic and 93% of the depressive patients showed preepisodic alterations. In the schizophrenic group the first alteration occured with a median of 10 weeks and in the depressive group with a median of 18 weeks before the onset of the acute episode. With regard to self-experienced vulner ability depressive cases were significantly less tolerant to stress, i . e. work under time pressure or unusual, unexpected requirements. Wit h regard to prodromal symptoms schizophrenics showed significantly mor e often interpersonal irritation and certain perception and thought di sturbances, whereas depressive patients reported more often adynamia a nd certain disturbances of proprioception. 73 % of the schizophrenic p atients and 90% of the depressive patients reacted to early symptoms w ith coping strategies. The preepisodic alterations in schizophrenic pa tients could be described in terms of mild psychotic productivity, ear ly symptoms of depressive patients could be described as a mild depres sive syndrome. Prospective studies are necessary to show if assessment of mild psychotic productivity could be used for early diagnosis and early intervention in schizophrenia.