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The Prodromal Phase of What?: A Metapsychiatric Analysis of the Prodromal Phase of Schizophrenia
Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
2008 (English)Doctoral thesis, monograph (Other academic)Alternative title
Prodromalfasen av vad? : En Metapsykiatrisk Analys av Prodromalfasen till Schizofreni (Swedish)
Abstract [en]

Prodromes of schizophrenia or prodromes of psychosis are a relatively new and expanding field of interest in psychiatric research. They are seen by some researchers as the initial symptom of having schizophrenia and have become a crucial topic in early psychosis research and intervention.

In this thesis current psychiatric research publications were analysed and eleven prospectively psychotic patients were interviewed. The research publications analysed were applyed on the information given by the patients, and the analysis showed that it was easy to find prodromes or prodrome-like phenomena in all the collected interviews. In addition a second analysis was performed on the material, a phenomenological psychological analysis, showing a more subject-oriented dimension of the interviews. This led to a further aim, analysing what explanations could be given of these phenomena.

There are probably many possibilities of getting the diagnosis of schizophrenia, but the examples in this study show that long-term abuse, often sexual actually can trigger psychiatric conditions corresponding to the definition of “prodromes of schizophrenia” according to some psychiatric publications as well as “schizophrenia” according to DSM

and ICD. This means that trauma and/or neglect proved to be a likely partial causal condition of the prodrome- like phenomena or schizophrenia to occur.

However, trauma has not been shown to be a necessary condition for the occurrence of prodrome-like phenomena or schizophrenia.

In the discussion of the results some consequences deriving from using different interpretations and explanations of the phenomena are analysed, for example using the prodromes of psychosis for the assessments of a coming psychosis, especially schizophrenia. I emphasize, because of the results of the phenomenological case analyses, the value of several dimensions of understanding prodrome-like phenomena as well as schizophrenia and schizophrenia-like conditions, especially as early as the initial phase.

Abstract [sv]

Prodromalfasen till schizofreni är ett relativt nytt begrepp och det utgör ett expanderande intresseområde för psykiatrisk forskning. Förändringar i prodromalfasen ses av vissa forskare som de första tecknen på schizofreni, och dessa fenomen har kommit i fokus speciellt vad gäller tidig upptäckt och intervention inom schizofreniforskning.

I denna avhandling analyseras åtskilliga psykiatriska texter som behandlar prodromalfasens fenomen. I den empiriska studien har elva personer, som senare utvecklat psykotiska symtom, intervjuats.  Två etablerade listor på prodromalfenomen testades på det empiriska materialet. Resultaten av den analysen visade att de gick att finna prodromalliknande fenomen hos alla intervjuade patienter. En andra fenomenologisk och mer subjektorienterad analys av det empiriska materialet genomfördes parallellt. Resultaten av de två analyserna ledde till ett tredje fokus för avhandlingen, nämligen frågan om möjliga kausalförklaringar till de prodromalliknande fenomenen.

Det finns förmodligen många orsaker till att en person uppvisar symtom som överensstämmer med diagnosen schizofreni. Exemplen i denna studie visar dock att långvariga, ofta sexuella, övergrepp kan leda till psykiatriska tillstånd som överensstämmer med fenomen i prodromalfasen och med själva diagnosen schizofreni enligt kriterierna i DSM-IV och ICD-10. Avhandlingens huvudhypotes är således att svåra trauman utgör delorsaker både till prodromalliknande fenomen liksom till tillstånd som diagnosticerats som schizofreni. Avhandlingens resultat ger dock ingen anledning att anta att trauman utgör nödvändiga betingelser för schizofreni.

I avhandlingens resultatdiskussion lyfter författaren fram några viktiga konsekvenser av olika definitioner av begreppen prodromalfenomen och schizofreni bl a vad avser förslag till terapeutiska interventioner. Mot bakgrund av resultaten från den fenomenologiska analysen understryks vikten av en bred förståelse av prodromalliknande fenomen liksom av fenomen som diagnosticeras som schizofreni.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2008. , 162 p.
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 457
Series
Linköping Dissertations on Health and Society, ISSN 1651-1646 ; 15
Keyword [en]
Schizophrenia, trauma, prodromal phase, prodromal phenomenon, qualitative method, causality
Keyword [sv]
Schizofreni, trauma, prodromalfas, prodromalfenomen, kvalitativ metod, kausalitet
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:liu:diva-15201ISBN: 978-91-7393-782-5 (print)OAI: oai:DiVA.org:liu-15201DiVA: diva2:113636
Public defence
2008-11-21, Aulan Hälsans Hus, Hus 240, Campus US, Linköpings universitet, Linköping, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2008-11-21 Created: 2008-10-23 Last updated: 2014-09-23Bibliographically approved

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Neubeck, Anna-Karin

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