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Self-experienced vulnerability, prodromal symptoms and coping strategies preceding schizophrenic and depressive relapses

Published online by Cambridge University Press:  16 April 2020

Andreas Bechdolf ,
Frauke Schultze-Lutter  and
Joachim Klosterkötter
Andreas Bechdolf*
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Joseph-Stelzmann Str. 9, 50924 Cologne, Germany
Frauke Schultze-Lutter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Joseph-Stelzmann Str. 9, 50924 Cologne, Germany
Joachim Klosterkötter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Joseph-Stelzmann Str. 9, 50924 Cologne, Germany
*
*E-mail address:[email protected] (A. Bechdolf).
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Summary

For the first time, the present study explores pre-episodic disturbances, i.e. self-experienced vulnerability and prodromal symptoms, and related coping strategies preceding schizophrenic and depressive relapses. After complete recovery from the acute episode, 27 patients with recurrent schizophrenic and 24 patients with recurrent depressive episodes were assessed retrospectively for pre-episodic disturbances and related coping strategies with the “Bonn scale for the assessment of basic symptoms—BSABS”. All (100%) of the schizophrenic and 23 (96%) of the depressive patients showed pre-episodic disturbances. Patients with schizophrenia showed significantly more often an increased emotional reactivity and certain perception and thought disturbances. Depressive patients reported significantly more often an impaired tolerance to certain stress and disorders of emotion and affect. Sixty-three percent of the schizophrenics and 87% of the depressives reacted to pre-episodic disturbances with coping strategies. The pre-episodic disturbances in patients with schizophrenia could be described in terms of mild psychotic productivity, those in depressives in terms of mild depressive syndrome. Future studies will have to show if these findings can be replicated in first episode or initial prodromal state samples and if the assessment of mild psychotic productivity and mild depressive syndrome can be used for early diagnosis and early intervention in schizophrenia and depression.

Keywords

Self-experienced vulnerabilityProdromal symptomsCopingSelf-experienced neuropsychological deficitsSchizophreniaAffective disorders
Type
Original article
Information
European Psychiatry , Volume 17 , Issue 7 , November 2002 , pp. 384 - 393
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

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References

Allen, J.J.Chapman, L.J.Chapman, J.P.Cognitive slippage and depression in hypothetically psychosis-prone college students. J Nerv Ment Dis 1987 175 347-353.CrossRefGoogle ScholarPubMed
American Psychiatric Association Diagnostic and statistical manual of mental disorders4th ed. (DSM IV)Washington, DC: APA; 1994.Google Scholar
Angst, J.Epidemiology of depressionHonig, AVan Praag, H.MDepression, Neurobiological, Psychopathological and Therapeutical Advances Wiley: Chichester; 1997; 17-30Google Scholar
Arboleda, C.Holzman, P.S.Thought disorder in children at risk for psychosis. Arch Gen Psychiatr 1985; 48 1004-1013.CrossRefGoogle Scholar
Birchwood, M.Smith, J.McMillan, F.Hogg, B.Prasad, R.Harvey, C.et alPredicting relapse in schizophrenia: The development and implementation of an early signs monitoring system using patients and families as observers, a preliminary investigation. Psychol M 1989; 19 649-656.CrossRefGoogle ScholarPubMed
Codoret, R.J.Widmer, R.B.Troughton, E.P.Somatic complaints. Harbinger of depression in primary care. J Affective Disord 1980; 2 61-70.Google Scholar
Chapman, L.J.Edwell, W.S.Chapman, J.P.Physical anhedonia, perceptual aberration, and psychosis proneness. Schizophr Bull 1980; 6 639-653.CrossRefGoogle ScholarPubMed
Chapman, L.J.Chapman, J.P.The search for symptoms predictive of schizophrenia. Schizophr Bull 1987; 13 497-503.CrossRefGoogle ScholarPubMed
Chapman, L.J.Chapman, J.P.Kwapil, T.H.Eckblad, M.Zinser, M.C.Putatively psychosis-prone subjects 10 years later. J Abnorm Psychol 1994; 103 171-183.CrossRefGoogle ScholarPubMed
Cutting, J.Dunne, F.Subjective experience of schizophrenia. Schizophr Bull 1989; 15 217-231.CrossRefGoogle ScholarPubMed
Dryman, A.Eaton, W.W.Affective symptoms associated with the onset of major depression in the community. Acta Psychiatr Scand 1991; 84 1-5.CrossRefGoogle Scholar
Eaton, W.W.Badawi, M.Melton, B.Prodromes and precursors: epidemiologic data for primary prevention of disorders with slow onset. Am J Psychiatr 1995; 152 967-972.Google ScholarPubMed
Ebel, H.Gross, G.Klosterkötter, J.Huber, G.Basic symptoms in schizophrenic and affective psychoses. Psychopathology 1989; 22 224-232.CrossRefGoogle ScholarPubMed
Fabisch, K.Fabisch, H.Langs, G.Macheiner, H.Fritz, W.Höngli, D.Basic Symptoms and their contribution to the differential typology of acute schizophrenic and schizoaffective disorders. Psychopathology 2001; 34 15-22.CrossRefGoogle ScholarPubMed
Fava, G.A.Kellner, R.Prodromal symptoms in affective disorders. Am J Psychiatr 1990; 148 823-830.Google Scholar
Fava, G.A.Grandi, S.Canestrari, R.Molnar, G.Prodromal symptoms in primary major depressive disorder. J Affective Disord 1991; 19 149-152.CrossRefGoogle Scholar
Fava, G.A.Subclinical symptoms in mood disorders: pathophysiological and therapeutic implications. Psychol M 1999; 29 47-61.CrossRefGoogle ScholarPubMed
Gaebel, W.Janner, M.Frommann, N.Pietzcker, A.Kopcke, W.Linden, M.et alProdromal states in schizophrenia. Compr Psychiatr 2000; 28 161-174.Google Scholar
Gross, G.Huber, G.Klosterkötter, J.Linz, M.Bonner Skala für die Beurteilung von Basissymptomen (BSABS; Bonn scale for the assessment of basic symptoms) Berlin: Springer; 1987.Google Scholar
Häfner, H.Riecher, A.Maurer, K.Meissner, S.Schmidtke, A.Fätenheuer, B.et alEin Instrument zur retrospektiven Einschätzung des Erkrankungsbeginns bei Schizophrenie (Instrument for the Retrospective Assessment of the Onset of Schizophrenia - “IRAOS”). Z Klin Psychol 1990; 12 230-255.Google Scholar
Häfner, H.Riecher-Rössler, A.Maurer, K.Fätkenheuer, B.Löffler, W.First onset and early symptomatology of schizophrenia. Eur Psychiatr Clin Neurosci 1992; 242 109-118.CrossRefGoogle ScholarPubMed
Hays, P.Modes of onset of psychotic depression. Br Med J 1964;; 779-784.CrossRefGoogle ScholarPubMed
Herz, M.Melville, C.Relapse in schizophrenia. Am J Psychiatr 1980; 137 801-812.Google Scholar
Hirsch, S.R.Jolley, A.G.The dysphoric syndrome in schizophrenia and its implications for relapse. Br J Psychiatry (Suppl 5) 1989;; 46-50.CrossRefGoogle ScholarPubMed
Hopkinson, G.The prodromal phase of the depressive psychosis Psychiatrica et. Neurologia 1965; 149 1-6.Google Scholar
Huber, G.Gross, G.Schüttler, R.Linz, M.Longitudinal studies of schizophrenic patients. Schizophr Bull 1980; 4 592-605.CrossRefGoogle Scholar
Huber, G.Konzeption der Einheitspsychose aus der Sicht der BasisstörungslehreMundt, C.hSaß, H.(H.rsg)Für und wider die Einheitspsychose New York: Thieme Stuttgart; 1992; 61-72.Google Scholar
Jackson, H.J.McGorry, P.D.Dudgeon, P.Prodromal symptoms of schizophrenia in first-episode psychosis: prevalence and specifity. Compr Psychiatr 1995; 36 241-250.CrossRefGoogle Scholar
Judd, L.L.Subsyndromal symptomatic depression. CNS Drugs 1994; 1 399-404.CrossRefGoogle Scholar
Kendler, K.S.McGuire, M.Gruenenberg, A.M.O'Hare, A.Spellman, M.Walsh, D.The Roscommon family study IV: affective illness, anxiety disorder and alcoholism in relatives. Arch Gen Psychiatr 1993; 50 952-960.CrossRefGoogle ScholarPubMed
Klosterkötter, J.The meaning of basic symptoms for the development of schizophrenic psychoses. Neurol Psychiatr Brain Res 1992; 1 30-41.Google Scholar
Klosterkötter, J.Das Vulnerabilitätskonzept bei Schizophrenen ErkrankungenMöller, H.JDeister, A.(H.rsg)Vulnerabilität für affektive und schizophrene Erkrankungen New York: Springer, Wien; 1995; 10-18.Google Scholar
Klosterkötter, J.Ebel, H.Schultze-Lutter, F.Steinmeyer, E.M.Diagnostic validity of basic symptoms. Eur Arch Psychiatry Clin Neurosci 1996; 246 147-154.CrossRefGoogle ScholarPubMed
Klosterkötter, J.Gross, G.Huber, G.Wieneke, A.Steinmeyer, E.Schultze-Lutter, F.Evaluation of the ‘Bonn scale for the assessment of basic symptoms - BSABS' as an instrument for the assessment of schizophrenia proneness: a review of recent findings. Neurol Psychiatr Brain Res 1997; 5 137-150.Google Scholar
Klosterkötter, J.Hellmich, M.Steinmeyer, E.Schultze-Lutter, F.Diagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiatr 2001; 58 158-164.CrossRefGoogle ScholarPubMed
Kupfer, D.J.Frank, J.M.Perel, J.M.The advantage of early treatment in recurrent depression. Arch Gen Psychiatr 1989; 46 771-775.Google ScholarPubMed
Larsen, T.K.Moe, L.C.Vibe-Hansen, L.Johanssen, J.O.Premorbid functioning vs. duration of untreated psychosis in one-year outcome in first-episode psychosis. Schizophr Res 2000; 45 1-9.CrossRefGoogle Scholar
Larsen, T.K.Friis, S.Haahr, U.Joa, I.Johanssen, J.O.Melle, I.et alEarly detection and intervention in first-episode schizophrenia: a critical review. Acta Psychiatr Scand 2001; 103 323-334.CrossRefGoogle ScholarPubMed
Lenzenweger, M.F.Psychometric high-risk paradigm, perceptual aberrations, and schizotypy: an update. Schizophr Bull 1994.CrossRefGoogle ScholarPubMed
Lieberman, J.Jody, D.Geisler, S.Alvir, J.Loebel, A.Szymanski, S.et alTime course and biologic correlates of treatment response in first-episode schizophrenia. Arch Gen Psychiatr 1993; 50 369-676.CrossRefGoogle ScholarPubMed
Loebel, A.D.Lieberman, J.A.Alvir, J.M.J.Mayerhoff, D.I.Geisler, S.H.Szmanski, D.O.Duration of psychosis and outcome in first episode schizophrenia. Am J Psychiatr 1992; 149 1183-1188.Google ScholarPubMed
Malla, A.K.Norman, R.M.G.Prodromal symptoms in schizophrenia. Br J Psychiatr 1994; 164 487-493.CrossRefGoogle Scholar
Marder, S.D.van Putten, T.Mintz, J.Lebell, M.McKenzie, J.Low and conventional dose maintenance therapy with fluphenazine decanoate: two-year outcome. Arch Gen Psychiatr 1987; 44 518-521.CrossRefGoogle ScholarPubMed
McGlashan, T.H.Johannessen, J.H.Early detection and intervention with schizophrenia: rationale. Schizophr Bull 1996; 20 201-222.CrossRefGoogle Scholar
Miller, T.McGlashan, T.Woods, S.W.Stein, K.Driesen, N.Corcoran, C.M.et alSymptom assessment in schizophrenic prodromal states. Psychiatr Q 1999; 70 273-287.CrossRefGoogle ScholarPubMed
Murphy, J.M.Nierenberg, A.A.Monson, R.R.Laird, N.M.Sobol, A.M.Leighton, A.H.Self-disparagemement as feature and forerunner of depression: findings from the Stirling County study. Comprehensive Psychiatr 0000;; 43 (1) 13-21.CrossRefGoogle Scholar
Nuechterlein, K.H.Vulnerability models for schizophrenia: state of the artHäfner, HGattaz, W.FJanzarik, WSearch for the Causes of Schizophrenia Berlin, Heidelberg, New York: Springer; 1987; 297-316.CrossRefGoogle Scholar
Parnas, J.Mednick, S.A.Early predictors of onset and course of schizophrenia and schizophrenia spectrumHäfner, HGattaz, W.FJanzarik, WSearch for the Causes of Schizophrenia Berlin, Heidelberg, New York: Springer; 1987; 34-47.Google Scholar
Schouten, H.J.A.Measuring pairwise agreement among many observers. Some improvements and additions. Biometr J 1982; 24 431-435.CrossRefGoogle Scholar
Subotnik, K.L.Nuechterlein, K.H.Prodromal signs and symptoms of schizophrenic relapse. J Abnorm Psychol 1988; 97 405-412.CrossRefGoogle ScholarPubMed
Süllwold, L.Huber, G.Schizophrene Basisstörungen Berlin: Springer; 1986.CrossRefGoogle Scholar
Thurm, I.Häfner, H.Perceived vulnerability, relapse risk and coping in schizophrenia. An explorative study. Eur Arch Psychiatr Neuro Sci 1987; 237 46-53.CrossRefGoogle ScholarPubMed
Winokur, G.Duration of illness prior to hospitalisation (onset) in the affective disorders. Neuropsychobiology 1976; 2 87-93.CrossRefGoogle ScholarPubMed
Young, M.A.Grabler, P.I.Rapidity of symptom onset in depression. Psychiatr Res 1985; 16 309-315.CrossRefGoogle ScholarPubMed
Yung, A.R.McGorry, P.D.The prodromal phase of first episode psychosis: past and current conceptualisations. Schizophr Bull 1996;; 22 (2): 353-370.CrossRefGoogle Scholar
Yung, A.R.Phillips, L.J.McGorry, P.D.McFarlane, C.A.Francey, S.Harrigan, S.et alPrediction of psychosis: a step towards indicated prevention of schizophrenia. Br J Psychiatr 1998; 172 (Suppl) 14-20.CrossRefGoogle ScholarPubMed
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