In the world of schizophrenia, you will never receive an absolute answer and certainty will always be questionable. Prodromal schizophrenia is no less ambiguous given that the onset and duration of this pre-diagnosis period can last from a few weeks to a couple of years. Since schizophrenia is a significantly debilitating disorder, it is important to treat symptoms as soon as they appear. In high risk individuals, or those who have a family history of schizophrenia, looking out for the prodromal stage is of vital importance.
What is Prodromal Schizophrenia?
The prodromal stage of schizophrenia is a one to two year period during which symptoms start to appear. People who develop schizophrenia almost always go through a prodromal stage. The prodromal stage can be thought of as a period of time during which individuals start to accumulate schizophrenia symptoms. When enough of those symptoms are present, the person is then diagnosed with schizophrenia. Remember that in order to be diagnosed with the disorder, the individual must present two or more positive, negative, or disorganized symptoms. Onset of the prodromal stage of schizophrenia is usually marked by a significant deterioration in certain aspects of behavior which begin to interfere with the quality of academic or professional work. During the prodromal stage, individuals may appear to be depressed and it is important that high-risk individuals be observed carefully as confusion between depression and prodromal schizophrenia is not uncommon. Detection of the early symptoms of schizophrenia is vital for full recovery.
What are the Symptoms of Prodromal Schizophrenia?
People with prodromal schizophrenia express mostly negative symptoms. These include social withdrawal, an increasing preference for being alone, increased sensitivity to noise or light, abnormal sleep patterns, increased anxiety, attention problems, and mild breaks from reality. A very characteristic symptom of prodromal schizophrenia, usually an indication of onset, is a sudden decrease in academic or professional performance. Keep in mind that prodromal symptoms usually occur during young adulthood or the early 20’s, so this particular symptom is most likely to affect academic performance. While not all individuals going through the prodromal period will suffer a psychotic break, development of schizophrenia or another psychological condition as a result of the prodromal symptoms is almost inevitable.
Is Prodromal Schizophrenia Curable?
Many symptoms of schizophrenia are treatable, yet the disorder itself or the combination of symptoms, are not completely curable. There is always risk of relapse if medication and other forms of treatment such as psychosocial therapy are discontinued. Furthermore, the prodromal period of schizophrenia is a predecessor to the full blown disorder, therefore it isn’t cured, rather- It escalates. During the prodromal stage of schizophrenia, psychosocial treatment is especially helpful because individuals are suffering mainly from negative symptoms. These symptoms, such as the inability to feel pleasure, disinterestedness, or inability to express emotion can be addressed through intervention. Programs that specialize in this type of intervention teach people with this condition to practice self-control and train them to display social behavior that allows them to interact normally with their peers and family. There is also a reward-based practice called token economy that teaches people with mostly negative symptoms to behave correctly in exchange for certain rewards. While these treatments do not fully cure schizophrenia, they allow people suffering from the disorder to live in a functional manner.
Depression vs Prodromal Schizophrenia
High risk individuals are always cautioned not to confuse the prodromal stage of schizophrenia with depression, but how exactly do these conditions differ? The most important difference between the prodromal stage of schizophrenia is that individuals diagnosed with it will eventually develop a full-blown type of schizophrenia whereas an individual suffering from depression will not. Although depression symptoms may worsen and cause, in the worse of circumstances, suicide, depression never escalates into a psychotic episode such as those seen in schizophrenic patients. Another obvious difference between prodromal schizophrenia and depression are that while depressed individuals suffer from chronic poor mood, prodromal individuals only appear to have poor mood based on their lack of expression. When talking to a depressed individual, the expression matches their account of how they feel whereas when talking to a prodromal schizophrenic, the expression of feeling and account are completely mismatched. Prodromal schizophrenics showing negative symptoms will often say that they feel happy or excited or positive about something, but their expression does not match their emotions. The depression-like symptoms come from negative schizophrenic symptoms and can be diagnosed by licensed psychologists or psychiatrists.
Will the Prodromal Stage Result in Schizophrenia?
Unfortunately, the prodromal stage of schizophrenia is one of the most certain indications of future diagnosis. The only thing to do in this situation is to treat prodromal symptoms and hope that a combination of psychotherapy and medication will keep the worse ones at bay and that development of positive and disorganized symptoms are delayed. As far as delaying the onset of full schizophrenia indefinitely, research is still pending. Individuals with a family history of schizophrenia between the ages of 16 and 25 should be observed carefully for symptoms resembling depression. With schizophrenia, early detection is key.
Summary and Conclusion
The prodromal stage of schizophrenia is hard to miss and often mistaken for depression. People with a family history of schizophrenia and other psychological disorders should be on the look out for depression-like symptoms which may indicate the onset of the prodromal stage. The prognosis of schizophrenia is more favorable for individuals who catch the symptoms in the early stages and seek treatment for them. If you or a loved one start to express some of the symptoms discussed in this article, please seek professional council. Remember that schizophrenia, although not completely curable, has favorable results for those that treat it early on.