Onset and Prodromal Phase as Determinants of the Course

Abstract

Under the contemporary conditions of mental health care, the first contact with mental health services of persons falling ill with schizophrenia is usually precipitated by the dramatic symptoms of the first psychotic episode. In most cases this event is preceded by an extended period of a more or less rapid accumulation of non-specific, negative and, finally, positive symptoms, which was already more or less known to Emil Kraepelin (1909--1915) and Eugen Bleuler (1911), the creators of the disease concept. In 1909 Kraepelin identified as the ``…prodromal signs of schizophrenia: small changes- in emotional life, irritability, loss of interest, overactivity and poor concentration''. The early, almost hidden illness phase is of great theoretical interest, but not easily accessible by research tools. For this reason it was long paid remarkably little attention.