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Early recognition of psychoses and bipolar disorders

What phases of a psychosis are there?

Psychoses have an individually very varied course. Just like every dream, every psychosis is also different. To make possible an orientation all the same, the possible course was subdivided into various phases. Their development can be very different however: (see model of the psychosis development).

The “Prodromal phase” (the “precursor phase”) is the phase from the start of the first mild psychic alterations to the continuous onset of psychotic symptoms (e.g. hallucinations or delusions). The average duration of this phase is around two to five years, in many persons afflicted it lasts even longer. As in the case of Daniel and Melissa, changes in mood, activity, the relationship with family members or friends or alterations of social behaviour or school / professional efficiency / productivity can be the first signs. These signs can occur alone or together with first “mild” psychotic symptoms. These “mild” psychotic symptoms include the first apparently delusional convictions, which are not based on facts or are abnormal (so-called “attenuated psychotic symptoms”), and hallucinations that stop by themselves within a week (so-called “brief limited intermittent psychotic symptoms”, BLIPS).

Mostly the prodromal phase then passes fluently to the duration of untreated psychosis (DUP), i.e. the psychotic symptoms now exists continuously; the person afflicted is still not treated however. In this phase the consequences for the prognosis are at their greatest, e.g. the persons afflicted lose their work, no longer go to school or strain relationships with family or friends (see possible consequences of a delayed start of treatment)


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