Self-experienced vulnerability. Prodromal symptoms and coping strategies preceding schizophrenic and affective episodes

For the first time, the present study explores self-experienced vulnerability, prodromal symptoms and coping strategies preceding schizophrenic and affective episodes. 33 schizophrenic and 29 depressive patients were assessed retrospectively for preepisodic alterations by means of the "Bonn Scale for the Assessment of Basic Symptoms - BSABS" after complete recovery from the acute episode. 97 % of the schizophrenic and 93% of the depressive patients showed preepisodic alterations. In the schizophrenic group the first alteration occured with a median of 10 weeks and in the depressive group with a median of 18 weeks before the onset of the acute episode. With regard to self-experienced vulnerability depressive cases were significantly less tolerant to stress, i. e. work under time pressure or unusual, unexpected requirements. With regard to prodromal symptoms schizophrenics showed significantly more often interpersonal irritation and certain perception and thought disturbances, whereas depressive patients reported more often adynamia and certain disturbances of proprioception. 73 % of the schizophrenic patients and 90% of the depressive patients reacted to early symptoms with coping strategies. The preepisodic alterations in schizophrenic patients could be described in terms of mild psychotic productivity, early symptoms of depressive patients could be described as a mild depressive syndrome. Prospective studies are necessary to show if assessment of mild psychotic productivity could be used for early diagnosis and early intervention in schizophrenia.