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Cited by 464Schizophrenia research and treatmentMental Health and PsychiatryPsychopathy, Forensic Psychiatry, Sexual Offending

The Initial Prodrome in Schizophrenia: Searching for Naturalistic Core Dimensions of Experience and Behavior

Moller, P., Husby, R.·2000·Schizophrenia Bulletin
DOI 10.1093/oxfordjournals.schbul.a033442
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Abstract

The scientific exploration of prepsychotic detection and intervention in psychosis has just commenced. To identify developing psychosis at prodromal stages, it is important to learn how patients and families perceive initial prodromes naturalistically. We must understand better what we are going to detect, because the essential components of this phase, particularly the subjective experiences, remain unsettled. In a series of 19 first episode DSM-IV schizophrenia patients, we explore prodromal phenomena in depth and identify potential core dimensions. On the basis of our findings, we describe experiences and behaviors that appear to be essential components of initial prodromes. The subjects reported serious difficulties interpreting and talking about prodromal experiences at the time these occurred, causing delayed identification. We report detailed reasons for this, pointing out vulnerable aspects of at-risk assessments. From eight proposed groups of experiences, two are highlighted as tentative core dimensions: "disturbance of perception of self" and "extreme preoccupation by and withdrawal to overvalued ideas." Four potential dimensions of prodromal behavior are also identified: (1) quit school, university, or job, or major school truancy, (2) marked and lasting observable shift of interests, (3) marked and lasting social passivity, withdrawal, or isolation, and (4) marked and lasting change in global appearance or behavior. We argue that the findings, the phenomena, and their significance in prodromes are valid because they are logical and coherent in light of clinical experience as well as the empirical literature of a full century.

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Crossref · 10.1093/oxfordjournals.schbul.a033442

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  • Social play deficits are observed in neurodevelopmental disorders such as autism spectrum disorders (ASD), early-onset schizophrenia, and attention-deficit/hyperactivity disorder.

    “Social play deficits are observed in neurodevelopmental disorders such as autism spectrum disorders (ASD), early-onset schizophrenia, and attention-deficit/hyperactivity disorder (Alessandri, 1992; Moller and Husby, 2000; Jordan, 2003).”

    From Sex-specific modulation of juvenile social play behavior by vasopressin and oxytocin depends on social context (2014) · cites this paper as Moller and Husby, 2000

    The Behavioral Dimensions (page not provided) reports social withdrawal, isolation, and avoidance during the prodrome of schizophrenia. It does not examine social play or establish play deficits specifically in early-onset schizophrenia. The other disorders in the citing sentence have separate citations. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Social play deficits are observed in neurodevelopmental disorders such as autism spectrum disorders, early-onset schizophrenia, and attention-deficit/hyperactivity disorder.

    “Conversely, social play deficits are observed in neurodevelopmental disorders such as autism spectrum disorders (ASD), early-onset schizophrenia, and attention-deficit/hyperactivity disorder (Alessandri, 1992; Moller & Husby, 2000; Jordan, 2003).”

    From Sex-specific modulation of juvenile social play by vasopressin (2013) · cites this paper as Moller & Husby, 2000

    In “The Behavioral Dimensions” (page unavailable), the paper reports social passivity, withdrawal, or isolation during the prodrome of schizophrenia. It does not report deficits in social play specifically or establish the claim for early-onset schizophrenia; the other disorders in the sentence have separate citations. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Play behaviour is disrupted during the prodromal phase of SCZ.

    “and play behaviour is disrupted during the prodromal phase of SCZ (Møller and Husby 2000).”

    From Neurexin1α knockout in rats causes aberrant social behaviour: relevance for autism and schizophrenia (2025) · cites this paper as Møller and Husby 2000

    The Behavioral Dimensions section reports marked, lasting shifts in interests during the initial schizophrenia prodrome, including shifts away from clubs, sports, music, and theater. That supports a change in recreational activities, but the paper does not specifically identify disrupted play behaviour. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • Deficits in play are core symptoms of neurodevelopmental disorders like autism spectrum disorder, attention-deficit/hyperactivity disorder, and early onset schizophrenia.

    “Indeed, deficits in play are core symptoms of neurodevelopmental disorders like autism spectrum disorder, attention-deficit/hyperactivity disorder, and early onset schizophrenia (Alessandri, 1992; Jones et al., 1994; Møller and Husby, 2000; Jordan, 2003; Helgeland and Torgersen, 2005)”

    From Social play experience in juvenile rats is indispensable for appropriate socio-sexual behavior in adulthood in males but not females (2023) · cites this paper as Møller and Husby, 2000

    The Behavioral Dimensions section identifies school or work impairment, shifts in interests, and social withdrawal as potential features of the schizophrenia prodrome, but does not identify deficits in play. Searches for play, childhood play, early-onset schizophrenia, autism, and ADHD found no passage addressing the attributed claim. The available passages have no page numbers. (LLM, conf=0.73)

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Cites

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Research works printed but not linked: 7

  1. Huber, G. Prodrome der schizophrenic [Prodromes of schizophrenia.] Fortschritte der Neurologie-Psychiatrie, 63(4): 131-138, 1995.
  2. Jaspers, K. Allgemeine Psychopathologie. Berlin, Germany: Springer, 1913.
  3. Klosterkotter, J.; Gross, G.; Huber, G.; Wieneke, A.; Steinmeyer, E.M.; and Schultze-Lutter, F. Evaluation of the "Bonn Scale for the Assessment of Basic Symptoms- BSABS" as an instrument for the assessment of schizophre- nia proneness: A review of recent findings. Neurology, Psychiatry and Brain Research, 5:137-150, 1997a.
  4. Miller, W.L., and Crabtree, B.F. Strategies of inquiry: Clinical research. In: Denzin, N.K., and Lincoln, Y.S., eds. Handbook of Qualitative Research. Thousand Oaks, CA; London, U.K.; New Delhi, India: Sage Publications, 1994. pp. 340-352.
  5. M0ller, P. First-episode schizophrenia: Do grandiosity, disorganization and acute initial development reduce duration of untreated psychosis? Comprehensive Psychiatry, in press.
  6. Parnas, J. On defining schizophrenia. In: Sartorius, N., and Maj, M., eds. WPA Series: Evidence and Experience in Psychiatry. Vol. 2. Schizophrenia. New York, NY: John Wiley and Sons, 1999.
  7. Schultze-Lutter, F.; Steinmeyer, E.M.; and Klosterkotter, J. Early detection of schizophrenia. Schizophrenia Research, in press.

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Authors
Moller, P., & Husby, R.
Affiliations
Diakonhjemmet Hospital (NO)
Venue
Schizophrenia Bulletin
Publisher
Oxford University Press (OUP)
Published
2000-01-01
Volume
26
Issue
1
Pages
217-232
ISSN
  • 0586-7614 (ISSN-L)
  • 1745-1701
DOI
10.1093/oxfordjournals.schbul.a033442
OpenAlex
W2137547795
Cited by
464
References
86
Citations by year
2026: 8 · 2025: 8 · 2024: 12 · 2023: 18 · 2022: 16 · 2021: 13 · 2020: 15 · 2019: 18 · 2018: 15 · 2017: 21 · 2016: 19 · 2015: 21 · 2014: 24 · 2013: 17 · 2012: 22
FWCI
16.61
Type
journal article
Language
en
Open access
closed
Locations
  • Schizophrenia Bulletin (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
Keywords
schizophrenia, prodromal symptoms
MeSH terms
Adolescent, Adult, Age Factors, Cognition Disorders, Female, Humans, Male, Psychiatric Status Rating Scales, Research Design, Schizophrenia, Schizophrenic Psychology, Self Concept, Sex Factors, Social Adjustment, Social Alienation, Reproducibility of Results, Age of Onset

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