Recognition of early warning signs in patients with schizophrenia: A review of the literature

Abstract

This article reviews and discusses the literature on the recognition of the early warning signs of psychosis. The assumption is that nurses, in the everyday exercise of their profession, can contribute to the prevention of psychotic relapse in schizophrenic patients by the early recognition of warning signs. First, the process of psychotic relapse and the factors that influence it are described. Then research on the early signs of psychosis is discussed. This article questions the most common early signs, when they occur, and who can recognize them. Then the predictive value of the early signs is considered: how well can psychotic relapse be predicted with these early signs? Finally, the research on the effects of early recognition and early intervention is discussed, primarily with respect to the question of whether psychotic relapses can actually be prevented by making use of preventive intervention strategies. The conclusion is that the preliminary results are hopeful and invite further research on such matters as the application of this intervention strategy within nursing practice.

How involuntary commitment impacts on the burden of care of the family

“…There is a widely accepted understanding that personality changes are an early warning sign of mental illness (van Meijel et al . 2004).…”

Mental Health Nursing and First Episode Psychosis

“…All of the articles showed the prevention of psychotic relapse to receive considerable attention within treatment programs although with differing levels of evidence (see Table 2) (Freeman, 2002;Gillam, 2002; van Meijel, 1996; van Meijel et al, 2003avan Meijel et al, , 2003bvan Meijel et al, , 2004van Meijel et al, 2006;Meulenbroeks et al, 1998;Renwick et al, 2009;Rogers, 2006;Sin, Taylor, & Kendall, 2009b;Sousa & Frazier, 2004;Stevens & Sin, 2005). Limited or lack of insight into symptoms, no recognition of the early signs of psychosis, poor adherence to medication, and life events were all reported to magnify the risk of psychotic relapse.…”

Psychiatrist's adherence: a new factor in relapse prevention of schizophrenia. A randomized controlled study on relapse control through telemedicine system

“…Recommended sampling frequency is equal or higher than once every 2 weeks (Van Meijel et al . ). Almost needless to say, standard clinical practice precludes this possibility due to a restricted number of outpatient visits.…”