Prodromal schizophrenia is an early phase of schizophrenia. It can affect a person in several subtle ways before they develop schizophrenia symptoms. People may mistake it for other conditions.

Schizophrenia is a chronic mental health condition that affects the way a person thinks, acts, and feels. People with schizophrenia may experience hallucinations, disordered thoughts, or other symptoms. They may seem like they have lost touch with reality.

Mental health professionals classify schizophrenia into stages with specific signs and symptoms. The first stage of schizophrenia is the prodromal stage. “Prodromal” refers to early signs or symptoms that indicate the onset of a condition before more specific symptoms occur.

This article discusses what prodromal schizophrenia is as well as its types and symptoms. It also discusses risk factors and treatments.

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Prodromal schizophrenia is a period of changeTrusted Source before the onset of schizophrenia. People with prodromal schizophrenia show changes from their previous behaviors and experiences. These changes are typically subtle. An individual generally does not yet show the full symptoms of schizophrenia.

Prodromal schizophrenia may last on average from 1–5 yearsTrusted Source. As the symptoms and signs of prodromal schizophrenia are similar to those of other conditions, healthcare and mental health professionals may overlook or misdiagnose them. Some people may confuseTrusted Source prodromal schizophrenia with depression.

Read more about schizophrenia.

There are two main typesTrusted Source of prodrome with different symptoms.

Pattern 1

People with pattern 1 prodrome experience changes not specific to schizophrenia, such as sleep disturbances that could be signs of different mental health conditions. They then experience early signs of schizophrenia, followed by symptoms of psychosis. Psychosis is a group of symptoms that resultTrusted Source in the loss of contact with reality.

Pattern 2

People with pattern 2 prodrome experience early symptoms specifically associated with schizophrenia. They then experience neurotic symptoms in response to them, such as anxiety or irritability. This is generally followed by symptoms of psychosis.

People with prodromal schizophrenia may experience symptoms that come on slowly. These symptoms typically change and developTrusted Source over time.

People may experienceTrusted Source gradual changes in their thinking, mood, and functioning in social situations before they experience symptoms of psychosis.

Although they may differTrusted Source from person to person, symptoms generally include:

  • depression
  • interrupted or disturbed sleep
  • trouble concentrating
  • a lack of motivation to complete tasks, called avolition
  • social isolation

People in the later stages of prodromal schizophrenia may experience mild and weakened psychotic experiences, also called attenuated psychotic experiences. These experiences may be an indication a person may develop symptoms of psychosis soon.

These attenuated psychotic experiences can vary from person to person and may include:

  • Referential thinking: This is a belief that ordinary events and the behavior of others have hidden meanings that relate to them.
  • Magical thinking: This is a belief that a person’s thoughts, feelings, or actions affect:
    • someone else’s behavior
    • the outcome of situations
  • Difficulties with reality testing: This is a person’s ability to tell the difference between their inner world and reality.
  • Poorly formed hallucinatory experiences: These include experiences such as:
    • mumbled voices

Other experiences may include:

  • erratic behavior
  • anxiety
  • withdrawal

Many people in the prodromal phase of schizophrenia may experience neurocognitive deficits. These are problems with:

  • memory
  • attention
  • learning
  • executive functioning, or how a person plans, remembers, and completes tasks

These deficits may fall between those of people without schizophrenia and those with. They may also predict who is at greater risk of developing schizophrenia.

Read about the stages of schizophrenia.

Experts believe that about 1 in 4Trusted Source people with prodromal schizophrenia progress to schizophrenia. Around 75% of people with schizophrenia previously passed through a prodromal symptom phase.

Researchers are still investigatingTrusted Source how people experience prodromal schizophrenia. Although they have identified several potential risk factors, they recommend further research. Some experts believe people may be more likely to have prodromal schizophrenia if they have certain genetic factors.

General risk factorsTrusted Source for schizophrenia include:

  • Genetics: Schizophrenia sometimes runs in families. Experts believe different combinations of genes make people more likely to develop it. However, having these genes does not necessarily mean a person will develop schizophrenia.
  • Environmental factors: Researchers believe some combination of a person’s environment and life experiences may influence the development of schizophrenia. These may include living in stressful or dangerous surroundings. Exposure to some viruses or nutritional problems before birth may also play a role.
  • Pregnancy and birth complications: People who experience complications before or during birth may be more likely to develop schizophrenia. These complications may have an effect on how their brain develops. They include premature labor, having a low birth weight, or a lack of oxygen during birth.
  • Differences in brain development: Studies have found small differences between the brains of people who have schizophrenia and those who do not. However, not everyone with schizophrenia has these changes. They can also occur in people without a mental illness.
  • Neurotransmitters: Neurotransmitters are chemicals that carry messages between the brain cells. People with schizophrenia may have different amounts of certain neurotransmitters. Medications that help reduce some neurotransmitters, such as dopamine, may also help some people with schizophrenia symptoms.

Mental health professionals aim to detectTrusted Source prodromal schizophrenia early to help prevent further effects. They also aim to treat a person for any symptoms of psychosis as soon as possible.

They may treat a person’s condition using antipsychotic medication, such as risperidone and olanzapine. These medications can help reduce prodromal symptoms as well as reduce the risk of the symptoms progressing to schizophrenia.

However, these medications may have side effects. Healthcare professionals may also use other treatments, such as:

  • D-serine, a naturally occurring amino acid normally present in a person’s brain
  • omega-3 fatty acids, which are substances found in certain foods, including several types of fish
  • supportive psychotherapy, which is a form of therapy that combines several different psychotherapy methods and focuses on providing support

Researchers are also investigating the use of newer treatments for prodromal schizophrenia, such as:

  • glucoraphanin, an antioxidant from broccoli sprouts
  • glutamate modulators, a newer form of antipsychotic medication

Some frequently asked questions about prodromal schizophrenia include:

What are the phases of schizophrenia?

The three phases of schizophrenia are prodromal, active, and residual. Each phase has distinct signsTrusted Source and symptoms. The active phase is also called acute.

What is the difference between schizophrenia and prodromal schizophrenia?

Prodrome schizophrenia has different symptomsTrusted Source and signs compared with schizophrenia. People show changes from their previous behavior but may not have the full symptoms of psychosis.

Prodromal schizophrenia is a period before the start of acute schizophrenia where a person may develop changes. During this period, people may display subtle differences in their behavior and experience. However, they do not yet experience symptoms of psychosis.

Not everybody with schizophrenia will go through a prodromal phase. It may also last several years and come on gradually over time. Experts are still investigating why some people experience prodromal phases.

There are several treatments healthcare and mental health professionals can use to help people with prodromal schizophrenia. These treatments help manage their symptoms. Researchers are also investigating new treatments.