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