The role of early warning symptoms in the detection and prevention of relapse in schizophrenia.
OBJECTIVE
The capacity of most clinical programs to detect early signs of relapse in schizophrenia and to implement strategies to prevent clinical progression remains unevaluated. The aim of this paper is to review the literature on the detection of relapse in schizophrenia and to draw conclusions that may be of use in the implementation of clinical programs.


METHODS
The relevant literature identified by standard search methods is explored and analysed.


RESULTS
Few studies have the capacity to directly address the question as to whether it is possible to predict relapse with a high degree of predictive power. Recently, the implementation of a multifactorial approach to relapse prediction appears to have offered substantial benefits.


CONCLUSIONS
The prediction of episodes of psychotic relapse is a realistic goal. Evidence indicates that interventions based upon programs of early detection can reduce rates of illness relapse. Prediction of relapse is most successful when implemented in a multifactorial way that involves specific and non-specific symptoms, structured ratings, clinical judgement, families, patients and clinicians.
Fitzgerald
P B
PB
Dandenong Psychiatry Research Centre, Monash University Department of Psychological Medicine, Victoria, Australia. paul.fitzgerald@med.monash.edu.au
D006801:Humans; D012559:Schizophrenia / Q000175:diagnosis* / Q000517:prevention & control*; D055502:Secondary Prevention; D013997:Time Factors