Yung A R, McGorry P D
Early Psychosis Prevention and Intervention Centre, Parkville, Victoria, Australia.
Schizophr Bull. 1996;22(2):353-70. doi: 10.1093/schbul/22.2.353.
The initial prodrome in psychosis is potentially important for early intervention, identification of biological markers, and understanding the process of becoming psychotic. This article reviews the previous literature on prodrome, including descriptions of symptoms and signs, and patterns and durations of prodromes in both schizophrenic and affective psychoses. Early detailed descriptions, achieved through mainly anecdotal reports, are compared with current conceptualizations, such as the DSM-III-R checklist of mainly behavioral items, which seeks to enhance reliability of measurement but at the expense of adequately describing the full range of phenomena. Current confusion about the nature of prodromal features and concerns regarding the reliability of their measurement are highlighted. This article proposes an alternative model for conceptualizing prodromal changes (the hybrid/interactive model) and discusses the different ways to view this phase. The need for a more systematic evaluation of the prodromal phase in first-episode psychosis is emphasized.
精神病的初始前驱期对于早期干预、生物标志物的识别以及理解精神病化过程具有潜在的重要意义。本文回顾了以往关于前驱期的文献，包括症状和体征的描述，以及精神分裂症和情感性精神病前驱期的模式和持续时间。通过主要是轶事报告获得的早期详细描述与当前的概念化进行了比较，例如主要是行为项目的《精神疾病诊断与统计手册第三版修订本》清单，该清单旨在提高测量的可靠性，但以充分描述全部现象为代价。文中强调了当前在前驱期特征性质方面的困惑以及对其测量可靠性的担忧。本文提出了一种概念化前驱期变化的替代模型（混合/交互模型），并讨论了看待这一阶段的不同方式。强调了对首发精神病前驱期进行更系统评估的必要性。
