ABSTRACT
This chapter explores the basis for a cognitive approach to early intervention based on the appraisal of early symptoms and its direct and indirect impact on relapse and delusion formation. Retrospective and prospective studies concur in finding ‘dysphoric’ symptoms the most commonly prevalent. The true predictive significance of prodromal signs can be clearly established only with prospective investigations. The prospective studies rather assume that prodromal and psychotic symptoms are discrete, dichotomous variables that may be scored as present or absent. Each study uses slightly different definitions of prodrome and relapse that may well contribute to differences in figures for sensitivity and specificity. The chapter considers the implications of the clinical studies in trying to interpret the empirical investigations. Such studies need to examine three issues: Whether prodromes of psychotic relapse exist; their timing in relation to full relapse, and how often the ‘prodromes’ fail as well as succeed to predict relapse.
