PSN-2. Identification of the prodrome of schizophrenia.

This study focuses on describing the prodrome of schizophrenia with a hospital-based patient population. Eligible patients were selected from all admissions WMMHC over a period of 1 year between July 2001 and June 2002. Patients without schizophrenia, or with a prior diagnosis of schizophrenia at our hospital, were eliminated from the study. Of the remaining 73 records 17 were included in the study group, 50 were used as control group and 6 were excluded. Patients included in study group had received a diagnosis of schizophrenia for the first time at WMMHC, while the patients in the control group had a prior diagnosis of schizophrenia made in other facilities. We analyzed the characteristics of patients at the time of their first schizophrenia diagnosis and at time of previous contact with our services. Mean and standard deviations for all the measurable data were calculated. We followed the progress of those patients at initial presentation and at subsequent evaluations. Patients included in the study group reported a distinct period of time from 1 year to 6 years, during which an insidious debut of perception changes appeared. In time they developed behavior changes that in many cases prompted psychiatric evaluation. The first psychotic episode was associated in most of the cases by a stressor. The most common presentation was with delusion rather than hallucinations at the time of the initial diagnosis with schizophrenia. Compared with the control group they had more family support, were more likely to be employed, had fewer hospitalizations, and experienced shorter hospital stays. Patients in the study group contacted a mental health care facility years before they were diagnosed with schizophrenia. Most of those individuals reported a distinct period of prodromal symptoms. Recognition of these symptoms could allow early identification and intervention before further deterioration occurs. A better understanding of the dynamics of initial symptoms is crucial.

Robert G. Bota, MD, Stuart Munro, MD, and Kemal Sagduyu, MD. Western Missouri Mental Health Center, Kansas City, MO.