What is Prodromal Schizophrenia?

What is Prodromal Schizophrenia?

Schizophrenia is a lifelong mental health condition in which people experience hallucinations and delusions that skew their perception of reality. While the onset of the condition varies from person to person, it typically occurs in three phases: the prodromal phase, the active phase, and the recovery phase. ¹

Throughout this article, we’re going to take a deeper look at these phases of schizophrenia and how they impact a person’s life. At the end, we invite you to ask further questions.

What is Prodromal Schizophrenia?

Prodromal schizophrenia is the first and earliest stage of the condition. During this period, a person may begin to notice changes in the way they think, feel, or behave. However, it’s unlikely they’ll begin to experience symptoms associated with schizophrenia, such as hallucinations or delusions. ²

This phase of schizophrenia doesn’t occur in everyone. In fact, some people may experience symptoms so mild that they don’t even realize the disease is progressing.

For this reason, it’s difficult for medical professionals to understand how long prodromal schizophrenia lasts.

In fact, most people of this stage are likely to notice their own symptoms before others around them do. With that said, the person struggling may pass it off as just a random bout and not consider serious treatment.

In some cases, people think they’re experience side effects from medication. Or that they’re struggling with another condition, such as anxiety, depression, or stress.

The prodromal phase of schizophrenia typically begins during adolescent years but can hold off until young adulthood. ³

When does prodromal phase of schizophrenia begin?

Prodromal Schizophrenia Symptoms

As mentioned, those in the prodromal phase typically only experience mild symptoms, many of which aren’t even noticeable. It’s not until the active phase when a person will start to notice symptoms commonly found in schizophrenia.

However, some people with prodromal schizophrenia may notice the following: ⁴

  • Anxiety
  • Concentration problems
  • Difficulty sleeping
  • Early signs of memory loss
  • Fatigue
  • Lack of appetite
  • Loss of motivation
  • Mood swings

According to “The Diagnostic and Statistical Manual of Mental Disorders,” there are nine specific symptoms an individual must experience in order to be diagnosed with schizophrenia. These include:

  • Abnormal behavior
  • Deviation in speech quality
  • Impairment to regular functioning
  • Lack of personal hygiene and grooming
  • Loss of energy
  • Social withdrawal
  • Strange experiences
  • Unusual behaviors
  • Weakened or inappropriate responses

Diagnosing Prodromal Schizophrenia

Out of all three stages, diagnosing prodromal schizophrenia is the most difficult. Since symptoms aren’t apparent and those struggling likely won’t make an issue of them, these symptoms are typically overlooked for other mental health conditions, such as depression.

For these reasons, it’s unlikely for schizophrenia to be diagnosed before the active phase.

Still, doctors may pinpoint certain aspects of schizophrenia during the prodromal phase that lead to a proper diagnosis. For example, they may recognize that someone in your family has struggled with schizophrenia and therefore, are able to conclude you’re more susceptible to it. ⁵

Genetics of schizophrenia

Other risk factors for schizophrenia include being exposed to an environment where toxins and viral infections are present. ⁶

In order to come to a proper diagnosis, there are a number of tests your doctor can run. These include psychiatrics and pediatric evaluations.

However, schizophrenia diagnosis has made a lot of progress over the last few decades. And doctors are now equipped with more tools that can lead to proper treatment. These include:

  • Bonn Scale for the Assessment of Basic Symptoms (BSABS)
  • Comprehensive Assessment of ARMS (CAARMS)
  • Scale for Prodromal Symptoms (SOPS)
  • Structured Interview for Prodromal Symptoms (SIPS)

It’s worth discussing these tests with your doctor if you believe you or a loved one is struggling with prodromal schizophrenia.

Furthermore, it’s worth noting that a 2001 study found the Bonn Scale for the Assessment of Basic Symptoms (BSABS) was very effective in detecting early stages of the condition. ⁷

How to Treat Prodromal Schizophrenia

Since there is no cure for schizophrenia, treatment involves the reduction of symptoms to the point where a personal can go onto live a normal life. In order to do this, patients will take a combination of medication and psychotherapy. ⁸

It should be noted that treatment typically occurs in the active phase, when symptoms are most apparent. It may be difficult to treat symptoms in the prodromal phase as they aren’t as obvious to the doctor.

For example, if you’re not yet experiencing hallucinations or delusions, it’s unclear which symptoms to target with medication and psychotherapy.


Currently, there is no medication available to target the prodromal phase of schizophrenia. However, a number of medications do exist to relieve symptoms during the active phase.

The most common of these are antipsychotics (such as Abilify, Rexulti, and Zyprexa) which can help to relieve delusions and hallucinations.

Depending on symptoms, a person may also receive antidepressants or mood stabilizers to reduce potential triggers of psychosis, such as stress.


If you are diagnosed with prodromal schizophrenia, it’s likely you’ll be recommended a form of psychotherapy. These can come in a variety of shapes and sizes, including individual or group therapy.

However, the most prominent psychotherapy for schizophrenia is cognitive behavioral therapy (CBT). This involves the patient finding the source of their symptoms and negative thought patterns and from there, developing coping mechanisms to overcome symptoms. ⁹

Psychotherapy for prodromal schizophrenia

Final Word

If you struggle with prodromal schizophrenia, it’s going to be difficult to treat as there currently are no set-and-stone treatment procedures. However, through psychotherapy, it’s likely that by identifying with symptoms early, you’re preventing the condition from becoming worse.

If you have a loved one who you believe is in the prodromal phase of schizophrenia, it’s important to contact a doctor. While treatment and diagnosis methods aren’t 100% accurate, they can determine whether or not your loved one is struggling with another condition.

Your Questions

Still have questions about prodromal schizophrenia?

We invite you to ask them in the comments section below. If you have any further advice to share – whether personal or professional – we’d also love to hear from you.

Reference Sources

¹ Washington State Health Care Authority: Early signs of psychosis

² Indian Journal of Psychiatry: Understanding the schizophrenia prodrome

³ Schizophrenia Bulletin: Age of Onset of Schizophrenia; Perspectives From Structural Neuroimaging Studies

⁴ HHS Public Access: Early signs, diagnosis and therapeutics of the prodromal phase of schizophrenia and related psychotic disorders

⁵ HHS Public Access: The Role of Genetics in the Etiology of Schizophrenia

⁶ Neuro Endocrinology Letters: Epidemiology and risk factors of schizophrenia

⁷ The Department of Psychiatry and Psychotherapy: Diagnosing Schizophrenia in the Initial Prodromal Phase

⁸ Pharmacy and Therapeutics: Schizophrenia: Overview and Treatment Options

⁹ Psychiatry (MMC): Cognitive Behavior Therapy for People with Schizophrenia

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