Recognizing and preventing relapse in patients with schizophrenia.

Although clinicians know that the acute symptoms of schizophrenia exacerbate and remit during the course of the illness, few studies detail the process leading to psychotic episodes. As an introduction to the problem of recognizing relapse in schizophrenic outpatients, the author discusses interviews that were conducted with one group of family members and two groups of schizophrenic patients, one whose psychotic episodes had just occurred and one whose episodes had occurred more than six months previously. The results confirm the existence of a prodromal period before relapse and the importance of prompt therapeutic interventions during such periods. Finally, the author presents a literature survey of the role of stress, the family, and psychotropic medication in relation to the relapse process, and discusses comprehensive therapeutic strategies that aim to either prevent or mitigate full-blown relapse.