New Clues to Identifying Earliest Signs of Psychosis

Psychosis and schizophrenia-related issues are often subtle and hard to notice in their earliest stages. Although some individuals who are at high risk of psychosis are easily identifiable due to family history and early onset of symptom manifestation, others are more difficult to identify.

Early diagnosis and treatment for schizophrenia and other psychoses, such as bipolar, can dramatically improve the course of the issues and overall quality of life for the individual. Some early indicators are decline in functionality, hallucinations, and psychotic episodes, but these usually appear after the illness has reached prodromal stages.

In an effort to find earlier warning signs, D. Koren of the Department of Psychology at the University of Haifa in Israel chose to focus on anomalies of self-experience (ASE). These not-quite-psychotic symptoms could provide insight into those at risk for future schizo or psychotic-type illnesses.

ASEs include feelings that one’s thoughts are not their own, but rather are anonymous; visual changes resulting in a feeling of moving backwards; and believing that one’s thoughts have tangible qualities and occupy physical space within one’s brain. These symptoms are not predictive of schizophrenia and are quite different than the subclinical symptoms of psychosis. Therefore, by determining if these symptoms exist in people who later develop schizophrenia or psychosis, they could be used as markers for those at risk for later mental health issues.

Koren assessed 82 nonpsychotic teenagers for levels of ASE, subclinical, and prodromal symptoms of psychosis and overall psychological distress. The participants were also measured for levels of psychosocial deterioration. The results revealed that 22% of the participants had ASE, while 28% had evidence of prodromal psychosis or schizophrenia. Although there were was an overlap between the two groups, these findings also show that there were unique differences in the classifications.

Further work needs to be done to determine the trajectories of ASE and how they affect later diagnosis. But for now, this study shows that despite the differences in symptoms between prodromal and ASE individuals, both could be viewed as markers for early identification. “In conclusion,” added Koren, “The present results provide first, preliminary concurrent support for the possibility that ASE are a clinical phenotype that characterizes the pre-onset phase of schizophrenia spectrum illnesses.”

Koren, D., et al. (2013). Disturbances of basic self and prodromal symptoms among non-psychotic help-seeking adolescents.Psychological Medicine 43.7 (2013): 1365-76. ProQuest. Web.

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  • Lucie


    July 2nd, 2013 at 4:24 AM

    While I think that it’s great to show the way that two illnesses can exhibit some similarities I also think that it is important to remember that they are two separate illnesses and should be treated as such. I think that there is this instinct to kind of lump many of these disorders together and assume that what works to treat one will work for all. I think that most of us on this site know that this isn’t true but I am not sure that overall this would be the perception of the general public. So while it is good o show how some are related it is even more important to show the differences so that all realize this is not a one size fits all kind of field.

  • kieran


    July 2nd, 2013 at 2:12 PM

    not too sure how well these things would be reported by that I have read so much about it I have a fair idea of how this might be.but imagine someone occasionally experiencing these things and never knowing this could be a sign!primary healthcare professionals should ask a small set of questions because they are like the corresponding agents for all health issues.

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