Prodromal states in schizophrenia

The vulnerability-stress-coping (VSC) model is the most influential heurist ic concept in understanding the course of schizophrenia, whose prodromal st atus still offers unsolved conceptual and methodological issues. Improved k nowledge about the prodromal phase would provide a better understanding of the developing psychopathology and psychophysiology of schizophrenia and co uld also be of predictive value to attune therapeutic actions to the course of the illness more precisely. To shed more light on the characteristics o f prodromal states, data from a German multicenter study on intermittent ve rsus maintenance neuroleptic long-term treatment in schizophrenia (ANI stud y) were reanalyzed with respect to the prevalence and profile, nature, time course, and predictive value of prodromal symptoms in impending relapse. T he results demonstrate that prodromes are a category of symptoms on their o wn, but they share variance with other symptom domains. Treatment side effe cts, psychotic symptoms, dysphoric mood, and social dysfunction are all ass ociated with prodromal states-the direction of this association, however, i s still to be clarified. Prodromal symptoms are also related to the neurole ptic treatment strategy and its relapse-preventive efficacy-findings that u nderscore neuroleptic maintenance medication in preventing both overt and s ubthreshold psychotic morbidity in schizophrenia. Copyright (C) 2000 by W.B . Saunders Company.