Relapse in Schizophrenia: Definitively not a Bolt from the Blue

Authors: F. Španiel, E. Bakstein, J. Anýž, Jaroslav Hlinka, T. Sieger, J. Hrdlička, N. Görnerová, C. Höschl
Publication year: 2018
Publication type: Článek v odborném periodiku
Periodical: Neuroscience Letters
Bibliographic citation: ŠPANIEL, F., BAKSTEIN, E., ANÝŽ, J., HLINKA, Jaroslav, SIEGER, T., HRDLIČKA, J., GÖRNEROVÁ, N., HÖSCHL, C. Relapse in Schizophrenia: Definitively not a Bolt from the Blue. Neuroscience Letters. 2018, 669(16 March), 68-74. ISSN 0304-3940. E-ISSN 1872-7972
Dostupné z: doi:10.1016/j.neulet.2016.04.044
DOI: 10.1016/j.neulet.2016.04.044
ID: 473672

Abstract

Background: Detailed study of the period before schizophrenic relapse when early warning signs (EWS) are present is crucial to effective pre-emptive strategies. Aims: To investigate the temporal properties of EWS self-reported weekly via a telemedicine system. Method: EWS history was obtained for 61 relapses resulting in hospitalization involving 51 patients with schizophrenia. Up to 20 weeks of EWS history per case were evaluated using a non-parametric bootstraptest and generalized mixed-effects model to test the significance and homogeneity of the findings. Results: A statistically significant increase in EWS sum score was detectable 5 weeks before hospitalization. However, analysis of EWS dynamics revealed a gradual, monotonic increase in EWS score across during the 8 weeks before a relapse. Conclusions: The findings - in contrast to earlier studies - suggest that relapse is preceded by a lengthy period during which pathophysiological processes unfold. These changes are reflected in subjective EWS.