Prodrome of Paranoid Schizophrenia with Episodic Type of Course and Schizoaffective Structure of Manifest Episode

Prodrome of paranoid schizophrenia with the episodic type of course (F20.1 and F20.2 according to ICD-10) and the schizoaffective structure of the episode was retrospectively studied. The pronounced and persistent affect, in particular depression in conjunction with hallucinations and/or delusions throughout the whole episode, served as the basis for an episode qualification as the schizoaffective structure. Diagnosis of schizophrenia was confirmed by the extremely low socio-demographic indicators at the time of the manifest episode, by the presence of catatonic or catatono-oneiroid symptoms in more than half of the patients, as well as an incongruence of hallucination plot and/or delusions against the dominant affect. In most cases, the affective symptoms were detected in clinical presentation of a prodrome and significantly more often in the form of depression, in comparison with bipolar and mixed affective disorders. Different clinical manifestations of negative symptoms were revealed in significantly more than half of the patients. The study showed that there is a significant frequency of negative manifestations in conjugation with depression in the prodrome.