In medicine, a prodrome is an early symptom that might indicate the start of
a disease before specific symptoms occur. It is derived from the Greek word
prodromos, meaning "precursor". Prodromes may be non-specific symptoms
or, in a few instances, may clearly indicate a particular disease, such as
the prodromal migraine aura. For example, fever, malaise, headache
and lack of appetite frequently occur in the prodrome of many infective
disorders. A prodrome can be the precursor to the onset of a chronic
neurological disorder such as migraine or epilepsy, where prodrome symptoms
include euphoria, scotoma, disorientation, aphasia, or
photosensitivity. It also refers to the initial in vivo
round of viral replication. Prodromal labour, mistakenly called
"false labour," refers to the early signs before labour starts.
In schizophrenia A prodrome for schizophrenia is the
period of decreased cognitive functioning that is postulated to
correlate with the onset of psychotic symptoms. The concept has been
reconsidered as the pathways to emerging psychosis have been investigated since
the mid-1990s. One example of the international paradigms aimed at
researching the prodrome is the North American Prodrome Longitudinal Study.
This study is concerned with brain development, hormones, and
neuropsychological functions that may play a role in risk for and prevention
of mental illness in young adulthood. The term at risk mental state is
sometimes preferred, as a prodromal period cannot be confirmed unless the
emergence of the condition has occurred. Prodrome, or psychosis risk syndrome as
it is also known, is a proposed syndrome to be used in the DSM-5 of psychiatry.
It is also defined as "the aura that precedes a psychotic break by up to two
or three years." Patients with this condition "still have 'insight' - a
pivotal word in psychiatric literature, indicating that a patient can still
recognize an altered worldview as a sign of illness, and not a revelation."
Prodrome is also sometimes called "attenuated psychotic symptoms
syndrome." Chairman of the DSM-IV Task Force, Allen Frances, has criticised the
concept of Psychosis Risk Syndrome on the grounds of a high rate of
inaccuracy, the potential to stigmatize young people given this label, the lack
of any effective treatment, and the risk of children and adolescents being given
dangerous antipsychotic medication. About one third of patients with
prodrome are diagnosed with schizophrenia or other psychosis in a
few years. In the North American Prodrome Longitudinal Study, researchers
found that 35 percent of "patients had a psychotic break within two and a half
years of enrolling at a clinic." 65 percent "found that their symptoms
passed or plateaued." A psychotic break is made statistically more likely if the
patient abuses certain drugs. Prodromal phase of common diseases and
conditions Diverticulitis – may worsen throughout
the first day, as it starts out as small pains in the torso and/or mild diarrhea,
and may slowly turn into vomiting and sharp pains in the lower left quadrant
of the abdomen. Herpes simplex – marked by tingling,
itching, and pain. Measles – marked by fever, rhinorrhea,
and conjuctivitis. Migraine – not always present, and
varies from individual to individual, but can include ocular disturbances such
as shimmering lights with reduced vision, altered mood, irritability,
depression or euphoria, fatigue, yawning, excessive sleepiness, craving
for certain food, stiff muscles, hot ears, constipation or diarrhea,
increased urination, and other visceral symptoms.
Varicella – may or may not feature a prodrome, but at least 37% of
unvaccinated children who contract chickenpox do have at least a mild
febrile prodrome. Parkinson's Disease - Loss of smell
Alzheimer's Disease - perhaps early impairments in behavior, personality and
language Controversial prodromes
"Pre-cold" - "itchy, scratchy, throat [and] runny nose"
Early warning signs of cancer See also
Postdrome References