The Prodromal Phase of Psychosis

The Prodromal Phase encompasses the period of early symptoms or changes in functioning which precede psychosis. It is the pre-illness period. Symptoms during this phase may be quite obvious or hardly noticeable. They can occur over a matter of days or months.

Common prodromal signs or symptoms can include the following, and it is important to note that a combination of symptoms rather than any one symptom would suggest a possible prodromal phase: Social withdrawal, a marked drop in functioning, uncharacteristic, peculiar behavior, increasing difficulty with concentration, heightened sensitivity to sights, sounds, smells or touch, loss of motivation or energy to participate in any activity, dramatic sleep and appetite changes, suspiciousness of others, unusual or exaggerated beliefs about personal powers or influences.

Individuals who are at risk of psychosis

Psychosis can affect individuals of any race, religion, or income. It is not the result of personal weakness, lack of character, or poor upbringing, despite many stigmatizing beliefs that this is the case. The development of a psychotic disorder appears to relate to a specific vulnerability. The major causes of this vulnerability are biological, but the development of a psychotic syndrome is influenced by both biological and environmental stressors. It can be caused by certain medical conditions as well.

The risk factors currently identified by international research are:

Age: adolescence or early adulthood (12 – 30). The average age of a young person coming to our program is 17.
Family history of a psychotic disorder such as schizophrenia or bipolar disorder—particularly in a close or immediate relative (parent or sibling).
A history of difficulty making friends, along with unusual thoughts and odd or eccentric behaviors (schizotypal personality disorder).
A marked change in behavior, emotions, or thinking for a month or more, especially when accompanied by social withdrawal and deterioration in school or work performance.

Sub-threshold psychotic symptoms that include suspiciousness or irrational (delusional) thinking, sporadic or fleeting hallucinations, and/or confused, disorganized communication that may wander off topic easily. Young people presenting most of these features may be at high risk for experiencing an acute psychotic episode. Course of onset and illness

We view psychosis as occurring within the context of an illness process during which the overt psychotic symptoms may be obvious in just one phase. The typical course of an initial psychotic episode can be conceptualized as occurring in three phases.

These are: the prodromal phase, the acute phase and the recovery phase.

Psychotic disorders rarely emerge fully developed.