First-episode psychosis in the military: a comparative study of prodromal symptoms

Objective: The objective of this study is to provide a retrospective descri ption of prodromal symptoms of young military servicemen with first-episode psychosis, and a comparison with first-episode non-psychotic disorders. Method: Thirty consecutive servicemen presenting with first-episode psychos is were studied. Thirty-four randomly selected servicemen from 123 with non -psychotic disorders served as comparison. A combination of unstructured an d semistructured interviews with the patient and other informants was used to describe the prodromal symptoms. Results: The most common prodromal psychotic symptoms were social withdrawa l (83%); anxiety (77%); sleep disturbance (77%); disturbance in attention, concentration or memory (73%); deterioration in studies in school (70%); de pressed mood (63%); odd behaviour (53%); and anger or irritability (53%). C ommon symptoms found in first-episode psychosis and non-psychotic patients included sleep disturbance, anxiety, depressed mood and anger or irritabili ty. Common symptoms that were associated with the psychotic prodrome were s ocial withdrawal (p < 0.001), deterioration in school results (p < 0.001) a nd disturbance in attention, concentration or memory (p < 0.001). The psych otic prodrome was also associated with apathy (p < 0.001), odd behaviour (p < 0.001), doing nothing (p = 0.004) and thought blocking (p = 0.04). Conclusion: Cognitive disturbances and attenuated negative symptoms appear to be more specific to the psychotic prodrome in young patients with first- episode psychosis.