Prodromal Symptoms of Relapse in a Sample of Egyptian Schizophrenic Patients

Background: Schizophrenic patients and familymembers often retrospectively report having observed a number ofnonpsychotic symptoms and/or certain alterations in behavior thatthey believe preceded any psychotic symptoms and behavior. Theidentification of possible relapse before its actual occurrenceand the timely intervention in management are expected to spareboth patient and family the suffering and pain of a fullschizophrenic episode. The aim of this study was to determine ifprodromal symptoms could be used as valid predictors of relapsein schizophrenic disorders and the relative diagnostic values ofthese symptoms in a sample of Egyptian schizophrenic patients.

Method: One hundred Egyptian patients withschizophrenic disorders (DSM-III-R criteria) that had recentlyrelapsed were retrospectively assessed for prodromal symptoms inthe month preceding relapse. They were compared with 2 controlgroups, 50 Egyptian nonrelapsing schizophrenic patients and 50healthy Egyptian individuals.

Results: Nonpsychotic symptoms were the mostcommon prodromal symptoms occurring in relapsing patients. Asignificant difference in frequency of prodromal symptoms wasfound for relapsing patients versus nonrelapsing patients (p <.001) and healthy controls (p < .05). Prodromal symptomsappear to have a relatively specific value for predictingsubsequent psychotic symptoms in those subjects who previouslyexperienced such symptoms.

Conclusion: Clusters of nonspecific prodromalsymptoms exist that significantly differentiate betweenrelapsing, nonrelapsing, and healthy controls. Fine-tuning of theidentification of these symptoms could be a plausible clinicaltool to be used by psychiatrists and general practitioners aliketo predict a possibility of an impending relapse.