Jun 29, 2005 - Evghenyi Filin, MD, for fruitful discussions and help, and Solomon Alfie, MD, and Walter Ricci, MD, .... The University of Missouri-Kansas.
CME
3
Original Research
CME
Factors Associated with the Prodromal Progression of Schizophrenia that Influence the Course of the Illness By Robert G. Bota, MD, Kemal Sagduyu, MD, and J. Stuart Munro, MD Council for Continuing Medical Education to provide Continuing Medical Education for physicians. Mount Sinai School of Medicine designates this educational activity for a maximum of 3.0 Category 1 credit(s) toward the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the educational activity. It is the policy of Mount Sinai School of Medicine to ensure fair balance, independence, objectivity and scientific rigor in all its sponsored activities. All faculty participating in sponsored activities are expected to disclose to the audience any real or apparent discussion of unlabeled or investigational use of any commercial product or device not yet approved in the United States. This activity has been peer-reviewed and approved by Eric Hollander, MD, professor of psychiatry, Mount Sinai School of Medicine. Review Date: November 1, 2005.
Needs Assessment
Schizophrenia is a debilitating illness resulting in significant human and financial costs. While a discourse on the topic of the schizophrenia prodrome has been present in the medical literature for over 70 years, the prodrome is poorly understood. Elucidation of the issue has implications for assessment, intervention, and prognosis.
Learning Objectives At the end of this activity, the participant should be able to: • Recognize the importance of the prodrome in the course of schizophrenia. • Describe various patterns by which the prodrome of schizophrenia might unfold. • Develop a rational approach to treatment based on the quality of the prodrome. • Formulate a general prognosis based on the quality of the prodrome.
Mount Sinai School of Medicine is accredited by the Accreditation
To Receive Credit for This Activity Read this article, and the two CME-designated accompanying articles, reflect on the information presented, and then complete the CME quiz found on pages 984 and 985. To obtain credits, you should score 70% or better. Termination date: December 31, 2007. The estimated time to complete this activity is 3 hours.
ABSTRACT Objective: This study examined factors influencing the prognosis of patients with different prodromal manifestations of schizophrenia and the association of diagnosis and antipsychotic treatment with the frequency of future acute inpatient care. Methods: Data was collected from the medical records of 24 patients initially diagnosed with schizophrenia. Results: Seventy-six percent of the patients (N=18) had at least one psychiatric assessment before the debut of schizophrenia. Patients who were assessed prior to the initial diagnosis of schizophrenia presented in two distinct
time frames. Patients in the first wave received a different Axis I diagnosis, depending on the phase of prodrome upon time of initial evaluation. Receiving any Axis I diagnosis during the prodromal stage in wave one correlated with an increased need for acute inpatient treatment (P
