Prodrome

Source: Wikipedia, the free encyclopedia.

In

migraine aura
.

For example,

epileptic seizure, where prodrome symptoms may include euphoria or other changes in mood, insomnia, abdominal sensations, disorientation, aphasia, or photosensitivity. Such a prodrome occurs on a scale of days to an hour before the episode, where an aura occurs more immediate to it.[citation needed
]

Prodromal labour, mistakenly called "false labour," refers to the early signs before labour starts.[2]

In mental health

The prodrome is a period during which an individual experiences some

subsyndromal stage or the early abnormalities in behavior, mood, and/or cognition before illness onset.[4] Early detection of the prodrome can create an opportunity to administer appropriate early interventions quickly to try to delay or decrease the intensity of subsequent symptoms.[5]

Schizophrenia

See also: Schizophrenia § Onset

negative symptoms that may have begun earlier, the individual may meet the diagnostic criteria for schizophrenia.[7] Although a majority of individuals who experience some of the symptoms of schizophrenia will never meet full diagnostic criteria, approximately 20–40% will eventually be diagnosed with schizophrenia.[8] One of the challenges of identifying and treating the prodrome is that it is difficult to predict who, among those with symptoms, are likely to meet full criteria later.[citation needed
]

Duration

The prodromal phase in schizophrenia can last anywhere from several weeks to several years, and comorbid disorders, such as major depressive disorder, are common during this period.[9]

Identification/assessments

Screening instruments include the Scale of Prodromal Symptoms[10][11] and the PROD-screen.[12][13]

Signs and symptoms of the prodrome to schizophrenia can be assessed more fully using structured interviews. For example, the Structured Interview for Prodromal Syndromes,[14][11] and the Comprehensive Assessment of At Risk Mental States (CAARMS)[15] are both valid and reliable methods for identifying individuals likely experiencing the prodrome to schizophrenia or related psychotic-spectrum disorders
.

There are ongoing research efforts to develop tools for early detection of at-risk individuals. This includes development of risk calculators[16] and methods for large-scale population screening.[17]

Interventions

Describing the schizophrenia prodrome has been useful in promoting

coping strategies to decrease positive psychosis symptoms.[8] Additionally, omega-3 fish oil supplements may help reduce prodromal symptoms.[8] Current guidelines suggest that individuals who are at "high risk" for developing schizophrenia should be monitored for at least one to two years while receiving psychotherapy and medication, as needed, to treat their symptoms.[18]

Bipolar disorder

Symptomology

There is also growing evidence that there is a prodromal phase before the onset of bipolar disorder (BD).[19] Although a majority of individuals with bipolar disorder report experiencing some symptoms preceding the full onset of their illness, the prodrome to BD has not yet been described systematically. Descriptive reports of bipolar prodrome symptoms vary and often focus on nonspecific symptoms of psychopathology, making identification of the prodromal phase difficult. The most commonly observed symptoms are too much energy, elated or depressed mood, and alterations in sleep patterns.[20] There are no prospective studies of the prodrome to bipolar disorder, but in the Longitudinal Assessment of Manic Symptoms (LAMS) study, which followed youth with elevated symptoms of mania for ten years,[21] approximately 23% of the sample met BD criteria at the baseline and 13% of which did not meet the criteria for BD at baseline eventually were diagnosed with BD.[22]

Duration

The reported duration of the prodrome to BD varies widely (mean = 27.1 ± 23 months);[20] for most people, evidence suggests that the prodromal phase is likely to be long enough to allow for intervention.

Identification/assessments

Symptoms consistent with the prodrome to BD can be identified through semi-structured interviews such as The Bipolar Prodrome Symptom Interview and Scale-Prospective (BPSS-P),[23] and the Semi-structured Interview for Mood Swings[24] and symptom checklists like the Young Mania Rating Scale (YMRS)[25] and the Hamilton Depression Scale (HAM-D).[26][20][19]

Interventions

Early intervention is associated with better outcomes for people with prodromal symptoms of BD. Interventions with some evidence of efficacy include medication (e.g.

emotion regulation and enhances functioning in both adults and adolescents.[27] Interpersonal and Social Rhythm Therapy (IPSRT) may be beneficial for youth at risk of developing BD by helping to stabilize their sleep and circadian patterns.[28] Psychoeducational Psychotherapy (PEP) may be protective in individuals at risk of developing bipolar disorder and are associated with a four-fold reduction in risk for conversion to BD.[29] This research needs to be explored further, however, it is currently thought to produce improvements in decreased stress due to social support and improved functioning through the skills developed in PEP. PEP can prove especially beneficial for individuals presenting transitional mania symptoms as it can assist caregivers in recognizing prodromal mania symptoms and knowing the next steps towards early intervention.[29] The key goals of this type of therapy are to provide psychoeducation about mood disorders and treatments, social support, and to build skills in symptom management, emotion regulation, and problem-solving and communication. This research is in its infancy, further investigations will be necessary to determine which methods lead to the best outcomes and for whom.[30]

In neurological conditions

Neurodegenerative diseases

Several

neurodegenerative diseases have a prodromal phase. Early impairments in behavior, personality and language may be detected in Alzheimer's disease.[31] In dementia with Lewy bodies, there is an identifiable set of early signs and symptoms that can appear 15 years or more before dementia develops.[32] The earliest symptoms are constipation and dizziness from autonomic dysfunction, hyposmia (reduced ability to smell), visual hallucinations, and rapid eye movement sleep behavior disorder (RBD).[33] RBD may appear years or decades before other symptoms.[34] In Parkinson's disease the loss of sense of smell may aid in earlier diagnosis.[35] Multiple sclerosis may have a prodromal phase.[36][37]

Migraine

The

yawning, excessive sleepiness, craving for certain food (e.g. chocolate), stiff muscles (especially in the neck), hot ears, constipation or diarrhea, increased urination, and other visceral symptoms.[38]

See also

References

  1. ISBN 9780323049375
    .
  2. ^ "Prodromal Labor". American Pregnancy Association. 8 June 2018.
  3. PMID 23932736
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  4. S2CID 529703
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  5. S2CID 149989676
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  6. ^
    PMID 29497198.{{cite journal}}: CS1 maint: DOI inactive as of January 2024 (link
    )
  7. PMID 11824483
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  8. ^
    PMID 20662758
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  9. S2CID 41802693
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  10. S2CID 25328195
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  11. ^
    PMID 14989408
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  12. PMID 12830303
    .
  13. PMID 23616773
    .
  14. S2CID 22928488
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  15. S2CID 145477493
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  16. PMID 28355424
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  17. PMID 33328055
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  18. PMID 16529334
    .
  19. ^
    PMID 20836910
    .
  20. ^
    PMID 27343882
    .
  21. PMID 21034684
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  22. PMID 21034685
    .
  23. PMID 24807784
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  24. S2CID 15290117
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  25. doi:10.1037/t20936-000. {{cite journal}}: Cite journal requires |journal= (help
    )
  26. PMID 14399272
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  27. PMID 28776930
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  28. PMID 24377402
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  29. ^
    PMID 20712750
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  30. PMID 26682997
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  31. PMID 18327642
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  32. PMID 32241955
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  33. S2CID 21628548. Archived
    (PDF) from the original on July 20, 2021. Retrieved July 20, 2021.
  34. PMID 31519472
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  35. S2CID 199663713
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  36. PMID 34155379
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  37. S2CID 204887642
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  38. S2CID 43574578
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External links
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