Predicting the onset of schizophrenia

  • J. Klosterkötter


Despite good progress in the treatment of schizophrenic psychoses in modern industrialized countries, in the majority of cases, the first diagnosis of and treatment for schizophrenia is still preceded by a succession of inadequate and, therefore, distressing contacts with counseling, medical and/or psychological services. Yet, as indicated by results from first episode research, the longer the start of an efficient therapy is delayed after the onset of first psychotic symptoms, i.e., the longer the ‘Duration of Untreated Psychosis’ (DUP), the more likely a negative clinical course becomes with regard to different outcome measures. A delayed begin of treatment correlates with:
  • Delayed and incomplete remission of symptoms [27, 37, 6, 44, 38]

  • Longer duration of hospitalization and higher risk for relapse [ 17]

  • Less compliance, higher burden for the family and “expressed emotion” level [7, 48, 49]

  • Weaker supportive social networks [35]

  • Higher risk of depression and suicide [1, 2, 16, 29, 50]

  • More stress in work and education-related situations [28, 34]

  • More substance abuse and delinquent behavior [23]

  • Possible cerebral pathophysiological changes [36, 52]

  • Significantly higher treatment costs [45]


Psychotic Symptom Prodromal Symptom Early Psychosis Basic Symptom Schizo Typal Personality Disorder 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2002

Authors and Affiliations

  • J. Klosterkötter
    • 1
  1. 1.Department of Psychiatry and PsychotherapyUniversity of CologneGermany

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