Löffler W, Häfner H
Zentralinstitut für Seelische Gesundheit, Arbeitsgruppe Schizophrenjeforschung, Mannheim.
MMW Fortschr Med. 2000 Mar 9;142(10):26-9.
Both Kraepelin and E. Bleuler reported that nonspecific symptoms are frequently present before the first psychotic symptoms manifest. In the ABC schizophrenia study, we were able to show that, in three-quarters of the cases, initial psychotic symptoms are preceded by a prodromal phase of several years standing that begins with non-specific signs such as negative and depressive symptoms. These early symptoms lead to social disabilities that--already before the onset of acute psychotic symptoms--have an adverse effect on the life situation of those who subsequently go on to develop schizophrenia. With the aim of preventing these early social consequences, patients at risk of developing schizophrenia should be identified in good time, and referred to early detection/intervention centers for a diagnostic work-up. In addition to the initial, non-specific symptoms that mark the beginning of the prodromal phase, basic disturbances also need to be considered, since they have considerable prognostic importance for the transition to psychosis. Other factors of importance are retarded development and behavioral anomalies in childhood and familial load, since premorbid risk factors are indicative of a congenital psychotic risk.
克雷佩林和E. 布鲁勒都报告称，在首次出现精神病性症状之前，非特异性症状常常已经存在。在ABC精神分裂症研究中，我们能够证明，在四分之三的病例中，最初的精神病性症状之前有数年的前驱期，该前驱期始于诸如阴性和抑郁症状等非特异性体征。这些早期症状会导致社会功能障碍，在急性精神病性症状发作之前，就已经对随后发展为精神分裂症的患者的生活状况产生不利影响。为了预防这些早期的社会后果，应该及时识别有发展为精神分裂症风险的患者，并将其转介到早期检测/干预中心进行诊断检查。除了标志着前驱期开始的最初的非特异性症状外，还需要考虑基本障碍，因为它们对于向精神病的转变具有相当大的预后重要性。其他重要因素包括儿童期发育迟缓、行为异常以及家族负担，因为病前危险因素表明存在先天性精神病风险。
