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Korean Journal of Schizophrenia Research 2003;6(1):36-47.
정신병 병전기 및 전구기의 진단과 평가
Numerous evidences have shown that biological and psychological deterioration of patients with signs and symptoms of psychosis can be avoided and their long-term outcome improved by reducing delays in initial treatment. Recently, intensive research efforts have been focused on early preventive intervention in prepsychotic patients. The primary intervention of psychosis in the premorbid or prodromal phase may reduce the incidence and prevalence of florid episodes of psychosis. The premorbid indicators of psychosis have been mainly obtained through the high risk studies with the offsprings of psychotic parents. To identify the individuals with high risk of developing psychosis, several diagnostic and assessment instruments on prodrome have been developed. Nonetheless, difficulties have been presented in defining the prodromal patients because of the nonspecific nature of prodrome. Some researchers have conducted clinical trials using their own diagnostic instruments and various treatment modalities in prodromal patients and have endorsed substantial benefits of early intervention. But some issues still need to be resolved, such as the high false positive rate of diagnostic criteria, the long-term efficacy and safety of antipsychotics use, ethical issues, and so on. This review article summarizes the previous literatures on premorbid and prodromal phase of psychosis, including descriptions of characteristic signs and symptoms, the development of diagnostic or assessment instruments and its use in early intervention programs, and discusses the related issues. (Schizophrenia Clinics 2003;6:36-47)
Key Words: Psychosis·Premorbid phase·Prodrome·Diagnosis
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