The Sequence of Firstever Onset of Symptoms

Arranging the early symptoms by their time of emergence in a time matrix of up to 60 months before first admission, we found that four depressive symptoms (depressed mood, suicide attempt, loss of self-confidence and feelings of guilt) tended to occur five to three years before first admission. In the second time window, four to two years before first admission, with a clear overlap with the depressive syndrome, all the negative symptoms appeared. After a short interval characterized by the emergence of dysphoric symptoms, positive symptoms appeared in the last year before first admission. This sequential pattern of emergence of various types of symptoms gives the impression of a regular sequence of stages reminiscent of Conrad's [21] and Docherty et al.'s [22] models. However, these stages of the early course of schizophrenia reconstructed on the basis of group means do not necessarily apply to individual cases.

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