Prodromal Quotes

PERIODIC MOOD-CHANGES We have already spoken of the affective concomitants of common migraines - elated and irritable prodromal states, states of dread and depression associated with the main phase of the attack, and states of euphoric rebound. Any or all of these may be abstracted as isolated periodic symptoms of relatively short duration - some hours, or at most two or three days, and as such may present themselves as primary emotional disorders. The most acute of these mood-changes, generally no more than an hour in duration, usually represents concomitants or equivalents of migraine aura. We may confine our attention at this stage to attacks of depression, or truncated manic-depressive cycles, occurring at intervals in patients who have previously suffered from attacks of undoubted (classical, common, abdominal, etc.) migraine. ~ Oliver Sacks

The changes that occur during the prodromal phase have been broadly characterised by Hafner and colleagues (Hafner et al., 1995), though other more intensive studies are reviewed and summarised in Yung et al. (1996). These and other studies (Jones et al., 1993) showed that although diagnostic specificity and ultimately potentially effective treatment comes with the later onset of positive psychotic symptoms, most of the disabling consequences of the underlying disorder emerge and manifest well prior to this phase. In particular, deficits in social functioning occur predominantly during the prodromal phase and prior to treatment. Hafner et al.
(1995) demonstrated clearly that the main factor determining social outcome two years after first admission for schizophrenia is acquired social status during the prodromal phase of the disorder. The importance of this phase was previously poorly appreciated because no conceptual ~ Max J. Birchwood

Persons in whom a crisis takes place pass the night preceding the paroxysm uncomfortably, but the succeeding night generally more comfortably. ~ Hippocrates