Prodrome of Paranoid Schizophrenia with Episodic Type of Course and Schizoaffective Structure of Manifest Episode

Alexander S. Bobrov*, PhD, ScD; Marina Yu. Rozhkova; Nina Yu. Rozhkova, PhD

Irkutsk State Medical Academy of Continuing Education; Irkutsk, Russian Federation.

*Corresponding author:  Prof. Alexander S. Bobrov, PhD, ScD. Irkutsk State Medical Academy of Continuing Education. Irkutsk, Russian Federation Email: bobrov_irkutsk@rambler.ru

Published: June 22, 2014.

Abstract: 

Prodrome of paranoid schizophrenia with the episodic type of course (F20.1 and F20.2 according to ICD-10) and the schizoaffective structure of the episode was retrospectively studied. The pronounced and persistent affect, in particular depression in conjunction with hallucinations and/or delusions throughout the whole episode, served as the basis for an episode qualification as the schizoaffective structure. Diagnosis of schizophrenia was confirmed by the extremely low socio-demographic indicators at the time of the manifest episode, by the presence of catatonic or catatono-oneiroid symptoms in more than half of the patients, as well as an incongruence of hallucination plot and/or delusions against the dominant affect. In most cases, the affective symptoms were detected in clinical presentation of a prodrome and significantly more often in the form of depression, in comparison with bipolar and mixed affective disorders. Different clinical manifestations of negative symptoms were revealed in significantly more than half of the patients. The study showed that there is a significant frequency of negative manifestations in conjugation with depression in the prodrome.

Keywords: 
prodrome; paranoid schizophrenia; schizoaffective variant; episodic type.
References: 
  1. Scheinina NC, Kotsyubinsky AP, Skoryk AI, Chumatchenko AA. Psychopathological diathesis. Predictors of mental diseases. St. Petersburg: "Hippocrates"; 2008. [Book in Russian].
  2. Gurieva VA, Gindikin VYa. Early detection of schizophrenia. High School of Psychology. M: Medicine; 2002. [Book in Russian].
  3. Krasnov VN. Schizophrenia. Chapter 21. Diagnosis of schizophrenia. Psychiatry. National Guidelines. M: ed. Group "GEOTAR Media"; 2009: 441-450. [Book in Russian].
  4. Häfner H, Maurer K, Löffler W, an der Heiden W, Munk-Jørgensen P, Hambrecht M, Riecher-Rössler A. The ABC Schizophrenia Study: a preliminary overview of the results. Soc Psychiatry Psychiatr Epidemiol 1998; 33(8): 380-6.
  5. Møller P, Husby R. The initial prodrome in schizophrenia: searching for naturalistic core dimensions of experience and behavior. Schizophr Bull 2000; 26(l):217-32.
  6. Gourion D, Gourevich R, Leprovost JB, Olié H Iôo JP, Krebs MO. Neurodevelopmental hypothesis in schizophrenia. Encephale 2004; 30(2): 109-18. [Article in French].
  7. Klosterkotter J, Hellmich M, Steinmeyer EM, Schultze-Lutter F. Diagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiatry 2001; 58(2): 158-64. Cited by Medvedev BE; references #21.
  8. Schultze-Lutter F, Ruhrmann S, Klosterkotter J. Can schizophrenia be predicted phenomenologically? In: Johannessen JO, Martindale B, Cullberg J, editors. Evolving psychosis. Different stages, different treatments. London, Routledge. 2006: 104-23. Cited by Medvedev BE; references #21.
  9. Teyssier JR. Prodromes of schizophrenia: consensus or confusion? Encephale 2013; Suppl 1: S1-7. [Article in French].
  10. Ruhrmann S, Schultze-Lutter F, Klosterkötter J. Early detection and intervention in the initial prodromal phase of schizophrenia. Pharmacopsychiatry 2003; Suppl 3: S162-167.
  11. Haroun N, Dunn L, Haroun A, Cadenhead KS. Risk and protection in prodromal schizophrenia: ethical implications for clinical practice and future research. Schizophr Bull 2006; 32(1):166-78.
  12. Hawkins KA, McClashan TH, Quinlan D, Miller TJ, Perkins DO, Zipursky RB, et al. Factorial structure of the scale of prodromal symptoms. Schizophr Res 2004; 68(2-3):339-47. Cited by Smulevich AB. Non-manifested stages of schizophrenia: psychopathology and therapy. Zh Nevrol Psikhiatr Im SS Korsakova 2005; 5:4-10. [Article in Russian].
  13. Cornblatt BA, Lencz T, Smith CW, Correll CU, Auther AM, Nakayama E. The schizophrenia prodrome revisited: a neurodevelopmental perspective. Schizophr Bull 2003; 29 (4): 633-51.
  14. Dragt S, Nieman DH, Veltman D, Becker HE, van de Fliert R, de Haan L, Linszen DH. Environmental factors and social adjustment as predictors of a first psychosis in subjects at ultra high risk. Schizophr Res 2011; 125(1):69-76.
  15. Yung AR, Nelson B, Tompson AD, Wood SJ. Should a “Risk Syndrome for Psychosis” be included in the DSM-V? Schizophr Res 2010;120(1-3):7-15.
  16. Miller TJ, McGlashan TH, Rosen JL, Cadenhead K, Cannon T, Ventura J, et al. Prodromal assessment with the structured  interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability. Schizophr Bull 2003; 29 (4): 703-715.  Cited by Mazaeva NA; reference #20.
  17. Yung AR, Nelson B, Stanford C, Simmons MB, Cosgrave EM, Killackey E, et al. Validation of “prodromal” criteria to defect individuals at ultra high-risk of psychosis: 2 year follow-up. Schizophr Res 2008; 105(1-3):10-7. Cited by Mazaeva NA; reference #20.
  18. McGlashan TH, Walsh BC, Woods SW.  The Psychosis-Risk Syndrome: Handbook for Diagnosis and Follow-up.  New York: Oxford University Press; 2010.
  19. Gurovich IYa. Prodrome of schizophrenia or "psychotic state at risk." Prodromal presentations. Chapter V. First psychotic episode (problems and psychiatric care). In:  Gurovich Iya & Schmookler AB, editors. M: MedPractice; 2010:77-110. [Book in Russian].
  20. Mazaeva NA. The early preventive interventions at endogenous diseases: reality and prospects. Psychiatry and psychopharmacotherapy 2010, 12 (5): 20-25. [Article in Russian].
  21. Medvedev VE. Diagnosis of latent course and the first episode of schizophrenia (review of foreign literature). Psych Pharmacother 2012; 6:65-69. [Article in Russian].
  22. Psychiatric thesaurus. Part I. Mental and behavioral disorders (F00-F99). Class V. The ICD-10 adapted for use in the Russian Federation. St. Petersburg; 2003:586. [Manual in Russian].
  23. Tiganov AS, Panteleeva GP, Tsutsulkovskaya MYa. Endogenous mental illness in the ICD-10 adapted version for use in RF. Psychiatry 2003; 1: 17-24. [Article in Russian].
  24. Nadzharov RA, Smulevich AB. Episodic-progradient (shift-like) schizophrenia. In: Snezhnevsky AB, editor. Manual of Psychiatry in 2 vols. M: Medicine; 1983; 1:314-322. [Manual in Russian].
  25. Tiganov AS.  Episodic-progradient (shift-like) schizophrenia. Section 1. Endogenous mental diseases. Manual of Psychiatry. M: Medicine; 1999; 1:432-437. [Manual in Russian].
  26. Tiganov AS. Episodic-progradient (shift-like) schizophrenia. Psychiatry. Manual for physicians in 2 vols. M: Medicine; 2012; 1:468-473. [Manual in Russian].
  27. Panteleeva GP, Dikaya VI. Schizoaffective psychosis. Classification. In Tiganov AS, editor. Manual of Psychiatry M: Medicine; 1999; 1: 640-644. [Manual in Russian].
  28. Panteleeva GP Bologov PV. Schizoaffective psychosis. Classification. In: Tiganov AS, editor. Manual for physicians in 2 vols. M: Medicine; 2012; 1:758-762. [Manual in Russian].
  29. Bobrov AS, Rozhkova M.Yu., Rozhkova N.Yu. Depressive schizoaffective disorder (typology and manifest episodes). Zh Nevrol Psikhiatr Im SS Korsakova 2013;113(3):15-20. [Article in Russian].
  30. Lenez T, Smith ChW, Auther AM, Correll CU, Cornblatt BA. The assessment of “prodromal schizophrenia”: unresolved issues and future direction. Schizophr Bull 2003; 29(4):717-28.  Cited by Gurovich IYa; references #19.
  31. Goloviznina AL. The clinicopsychological differentiation of patients with psychogenic (non-psychotic) depression. Ross Psych J 2004; 4: 4-8. [Article in Russian].

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Int J Biomed. 2014; 4(2):92-98. © 2014 International Medical Research and Development Corporation. All rights reserved.