Prodromal symptoms

Apart from the well-established symptoms described so far, there are what are called prodromal symptoms. The term ‘prodrome’ generally signifies the prepsychotic period before the onset of the illness, or that preceding an before the onset of the illness, or that preceding an episode of relapse. Initial prodrome is defined as the period of time from the first change in an individual until the development of clear psychotic symptoms.

Very often, a patient has similar prodromal symptoms before each episode of relapse. It is important for both the patients and their family members to be aware of this in order to facilitate early intervention.

Co-morbidity with schizophrenia

Persons with schizophrenia also suffer from a greater degree of co-morbidity with associated conditions like alcohol abuse, abuse of stimulant drugs, caffeine, tobacco and others. An increased risk of HIV/AIDS, suicides and other mental disorders are also associated with schizophrenia. The course and outcome from schizophrenia also worsens over a period of time due to the presence of co-morbid conditions.

What is not schizophrenia?

Another psychiatric disorder is manic-depressive psychosis. This is characterized mainly by episodes of elevated mood and increased activity (called hypomania or mania in medical terms) which could alternate with spells of depression. Some people can have repeated episodes of either hypomania or depression alone. It is sometimes difficult to clinically distinguish this from schizophrenia.

Schizophrenia is not a splitting of the personality into different parts, as portrayed in Dr Jekyll and Mr Hyde or The Three Faces of Eve. Nevertheless, the idea that schizophrenia means split personality is pervasive. When people in everyday life describe something as ‘schizophrenic’, they mean a “split into contrasting parts”.

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WHO Regional Office for South-East Asia