Abstract
Under the contemporary conditions of mental health care, the first contact with mental health services of persons falling ill with schizophrenia is usually precipitated by the dramatic symptoms of the first psychotic episode. In most cases this event is preceded by an extended period of a more or less rapid accumulation of non-specific, negative and, finally, positive symptoms, which was already more or less known to Emil Kraepelin (1909–1915) and Eugen Bleuler (1911), the creators of the disease concept. In 1909 Kraepelin identified as the “…prodromal signs of schizophrenia: small changes- in emotional life, irritability, loss of interest, overactivity and poor concentration”. The early, almost hidden illness phase is of great theoretical interest, but not easily accessible by research tools. For this reason it was long paid remarkably little attention.
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References
APA — American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn, revised. Washington DC
Albus M, Maier W (1995) Lack of gender differences in age at onset in familial schizophrenia. Schizophrenia Res 18:51–57,
Andreasen NC (1983) The scale for the assessment of negative symptoms (SANS). University of Iowa, Iowa City
Beiser M, Erickson D, Flemming JAE, Iacono WG (1993) Establishing the onset of psychotic illness. Am J Psychiatry 150:1349–1354
Biehl H, Maurer K, Schubart, C, Krumm B, Jung E (1986) Prediction of outcome and utilization of medical services in a prospective study of first onset schizophrenics — results of a prospective 5-year follow-up study. Eur Arch Psychiatry Neurol Science 236:139–147
Biehl H, Maurer K, Jablensky A, Cooper JE, Tomov T (1989) The WHO Psychological Impairments Rating Schedule (WHO/PIRS). I. Introducing a new instrument for rating observed behaviour and the rationale of the psychological impairment concept. Br J Psychiatry 155 (suppl 7):68–70
Bleuler E (1911) Dementia praecox oder Gruppe der Schizophrenien. In: Aschaffenburg G (ed) Handbuch der Psychiatric Deuticke, Leipzig, pp 1–420
Carpenter W, Heinrichs D (1983) Early intervention, time limited targeted pharmacotherapy for schizophrenia. Schizophrenia Bull 9:533–542
Choquet M, Ledoux S (1994) Epidemiologic et adolescence. In: Confrontations psychiatriques, vol 27 (no 35). Rhone-Poulenc rorer specia, Paris, pp 287–309
Conrad K (1958) Die beginnende Schizophrenic Versuch einer Gestaltanalyse des Wahns. Thieme, Stuttgart New York
Cutting J, Dunne F (1989) Subjective experience of schizophrenia. Schizophrenia Bull 15:217–231
DeLisi LE, Bass N, Boccio A, Shilds G, Morganti, C, Vita A (1994) Age of onset in familial schizophrenia. Arch Gen Psychiatry 51:334–335
Docherty JP, van Kammen DP, Siris SG, Marder SR (1978) Stages of onset of schizophrenic psychosis. Am J Psychiatry 135:420–426
Döpfner M, Pluck J, Berner W, Fegert JM, Huss M, Lenz K, Schmeck K, Lehmkuhl U, Poustka F, Lehmkuhl G (1997) Mental disturbances in children and adolescents in Germany. Results of a representative study: age, gender and rater effects. Z Kinder Jugendpsychiatr Psychother 25:218–233
Dunham HW (1965) Community and schizophrenia: an epidemiological analysis. Wayne State University Press, Detroit
Ebel H, Gross G, Klösterkotter J, Huber G (1989) Basic symptoms in schizophrenia and affective psychoses. Psychopathology 22:224–232
Foulds GA, Bedford A (1975) Hierarchy of classes of personal illness. Psychol Med 5:181–192
Freeman H, Alpert M (1986) Prevalence of schizophrenia in an urban environment. Br J Psychiatry 149:603–611
Gardner EL, Lowinson JH (1991) Marijuana’s interaction with brain reward systems: update 1991. Pharmacol Biochem Behav 40:571–580
Gorwood P, Leboyer M, Jay M, Payan C, Feingold J (1995) Gender and age at onset in schizophrenia: impact of family history. Am J Psychiatry 152:208–212
Griesinger W (1861) Pathologie und Therapie psychischer Krankheiten, 2nd edn. Adolph Krabbe, Stuttgart
Gross G (1969) Prodrome und Vorpostensyndrome schizophrener Erkrankungen. In: Huber G (ed) Schizophrenic und Zyklothymic Ergebnisse und Probleme. Thieme, Stuttgart, pp 177–187
Gross G, Huber G, Klösterkotter J, Linz M (1987) Bonner Skala für die Beurteilung von Basis-symptomen (BSABS: Bonn Scale for the Assessment of Basic Symptoms). Springer, Berlin Heidelberg New York
Häfner H (1996) The epidemiology of onset and early course of schizophrenia. In: Häfner H, Wolpert EM (eds) New research in psychiatry. Hogrefe & Huber Publishers, Seattle Toronto, pp 33–60
Häfner H (1998 a) Ist es einzig die Krankheit? In: Möller H-J, Müller N (eds) Schizophrenic — Moderne Konzepte zu Diagnostik, Pathogenese und Therapie. Springer, Wien New York, pp 37–59
Häfner H (1998b) Neues zum Verlauf der Schizophrenic In: Fleischhacker WW, Hinterhuber H, Meise U (eds) Schizophrene Storungen. State of the art II. Verlag Integrative Psychiatric, Innsbruck, pp 20–55
Häfner H, Riecher-Rössler A, Hambrecht M, Maurer K, Meissner S, Schmidtke A, Fätkenheuer B, Löffler W, an der Heiden W (1992) IRAOS: an instrument for the retrospective assessment of the onset of schizophrenia. Schizophrenia Res 6:209–223
Häfner H, Maurer K, Löffler W, Riecher-Rössler A (1993) The influence of age and sex on the onset and early course of schizophrenia. Br J Psychiatry 162:80–86
Häfner H, Maurer K, Löffler W, Bustamante S, an der Heiden W, Riecher-Rossler A, Nowotny B (1995 a) Onset and early course of schizophrenia. In: Häfner H, Gattaz WF (eds) Search for the causes of schizophrenia, vol III. Springer, Berlin Heidelberg New York, pp 43–66
Häfner H, Nowotny B, Löffler W, an der Heiden W, Maurer K (1995 b) When and how does schizophrenia lead to social deficits? Eur Arch Psychiatry Clin Neurosci 246:17–28
Häfner H, Maurer K, Löffler W, Nowotny B (1996) Der Frühverlauf der Schizophrenic Zeitschrift für Medizinische Psychologie 5:22–31
Häfner H, an der Heiden W, Behrens S, Gattaz WF, Hambrecht M, Löffler W, Maurer K, Munk-Jørgensen P, Nowotny B, Riecher-Rössler A, Stein A (1998 a) Causes and consequences of the gender difference in age at onset of schizophrenia. Schizophrenia Bull 24:99–113
Häfner H, Hambrecht M, Löffler W, Munk-Jørgensen P, Riecher-Rössler A (1998b) Is schizophrenia a disorder of all ages? A comparison of first episodes and early course across the life-cycle. Psychol Med 28:351–365
Häfner H, Maurer K, Löffler W, an der Heiden W, Munk-Jørgensen P, Hambrecht M, Riecher-Rössler A (1998 c) The ABC schizophrenia study: a preliminary overview of the results. Soc Psychiatry Psychiatr Epidem 33:380–386
Hambrecht M, Häfner H (1996) Substance abuse and the onset of schizophrenia. Biol Psychiatry 40:1155–1163
Hirsch SR, Jolley AG (1989) The dysphoric syndrome in schizophrenia and its implications for relapse. Br J Psychiatry 155 (suppl 5):46–50
Huber G, Gross G, Shüttler R (1979) Schizophrenic Eine Verlaufs- und sozialpsychiatrische Langzeitstudie. Springer, Berlin Heidelberg
Jackson HJ, McGorry PD, Dudgeon P (1995) Prodromal symptoms of schizophrenia in first-episode psychosis: Prevalence and specificity. Compr Psychiatry 36:241–250
Jones PB, Done DJ (1997) From birth to onset: a developmental perspective of schizophrenia in two national birth cohorts. In: Keshavan MS, Murray RM (eds) Neurodevelopmental and adult psychopathology. Cambridge University Press, Cambridge, pp 119–136
Jung E, Krumm B, Biehl H, Maurer K, Bauer-Schubart C (1988) DAS-M: Mannheimer Skala zur Einschätzung Sozialer Behinderung. Beltz, Weinheim
Klosterkötter J (1998) Kann man schizophrene Störungen schon in der Prodromalphase vor der psychotischen Erstmanifestation erkennen? ZNS Journal Forum für Psychiatrie und Neurologie 18:24–31
Könnecke R, Häfner H, Maurer K, Löffler W, an der Heiden W (1999) The main risk factors for schizophrenia: an increased familial load and pre- and perinatal complications antagonize the protective effect of oestrogen in women. Schizophrenia Res (accepted for publication)
Kovasznay B, Fleischer J, Tanenberg-Karant M, Jandorf L, Miller AD, Bromet E (1997) Substance use disorder and the early course of illness in schizophrenia and affective psychosis. Schizophrenia Bull 23:195–201
Kraepelin E (1896) Psychiatrie, 5th edn. Barth, Leipzig
Kraepelin E (1909–1915) Psychiatrie, vol 1–4. Barth, Leipzig
Lewine RJ (1980) Sex differences in age of symptom onset and first hospitalization in schizophrenia. Am J Orthopsychiatry 50:316–322
Lindelius R (1970) A study of schizophrenia. Acta Psychiatr Scand Suppl 216
Loebel AD, Lieberman JA, Alvir JMJ, Mayerhoff DI, Geisler SH, Szymanski SR (1992) Duration of psychosis and outcome in first-episode schizophrenia. Am J Psychiatry 149:1183–1188
Maurer K, Häfner H (1996) Früher Symptomverlauf und Defizite in der sozialen Entwicklung im Beginn der Schizophrenic In: Saß H (ed) Psychopathologische Methoden und psychia-trische Forschung. Gustav Fischer, Jena Stuttgart, pp 141–155
Maurer K, Könnecke R, Löffler W, Häfner H (1998) Some new results from the ABC study on early course and recognition. Neurology, Psychiatry and Brain Research 6:9–18
McGorry PD, Edwards J, Mihalopoulos C, Harrigan SM, Jackson JH (1996) EPPIC: An evolving system of early detection and optimal management. Schizophrenia Res 22:305–326
Mueser KT, Bellack AS, Blanchand JJ (1992) Comorbidity of schizophrenia and substance abuse: implications for treatment. J Consult Clin Psychol 60 (6):845–856
Perkins KA, Simpson JC, Tsuang MT (1986) Ten-year follow-up of drug abusers with acute or chronic psychosis. Hosp Comm Psychiatry 37:481–484
Salokangas RKR, Stengard E, Räkköläinen V, Kaljonen IHA (1987) New schizophrenic patients and their families (English summary). In: Reports of Psychiatrica Fennica, No 78. Foundation for Psychiatric Research in Finland, pp 119–216
Shepherd M, Watt D, Falloon I, Smeeton N (1989) The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics. Psychol Med Monogr Suppl 15
Smith J, Hucker S (1994) Schizophrenia and substance abuse. Br J Psychiatry 165:13–21
WHO — World Health Organization (1988) Psychiatric Disability Assessment Schedule (WHO/ DAS). WHO, Geneva
Wing JK, Cooper JE, Sartorius N (1974) Measurement and classification of psychiatric symptoms: An instruction manual for the PSE and CATEGO program. Cambridge University Press, London
Yung AR, McGorry PD, McFarlane CA, Jackson HJ, Patton GC, Rakkar A (1996) Monitoring and care of young people at incipient risk of psychosis. Schizophrenia Bull 22:283–303
Yung AR, Phillips LJ, McGorry PD, McFarlane CA, Francey S, Harrigan S, Patton GC, Jackson HJ (1998) Prediction of psychosis. A step towards indicated prevention of schizophrenia. Br J Psychiatry 172 (suppl 33):14–20
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© 1999 Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt
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Häfner, H. et al. (1999). Onset and Prodromal Phase as Determinants of the Course. In: Gattaz, W.F., Häfner, H. (eds) Search for the Causes of Schizophrenia. Steinkopff. https://doi.org/10.1007/978-3-642-47076-9_3
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