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Prodrome

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In <a href="Medicine" title="Medicine">medicine</a>, a prodrome is an early <a href="Medical_sign" class="mw-redirect" title="Medical sign">sign</a> or <a href="Symptom" class="mw-redirect" title="Symptom">symptom</a> (or set of signs and symptoms, referred to as prodromal symptoms<a href="#cite_note-:6-1">[1]</a>) that often indicates the onset of a <a href="Disease" title="Disease">disease</a> before more diagnostically specific signs and symptoms develop. More specifically, it refers to the period between the first recognition of a disease's symptom until it reaches its more severe form.<a href="#cite_note-:6-1">[1]</a> It is derived from the Greek word prodromos, meaning "running before".<a href="#cite_note-2">[2]</a> Prodromes may be <a href="Non-specific_symptoms" class="mw-redirect" title="Non-specific symptoms">non-specific symptoms</a> or, in a few instances, may clearly indicate a particular disease, such as the prodromal <a href="Migraine_aura" class="mw-redirect" title="Migraine aura">migraine aura</a>.

For example, <a href="Fever" title="Fever">fever</a>, <a href="Malaise" title="Malaise">malaise</a>, <a href="Headache" title="Headache">headache</a> and lack of appetite frequently occur in the prodrome of many <a href="Infection" title="Infection">infective</a> disorders. A prodrome can be the early precursor to an episode of a chronic <a href="Neurological" class="mw-redirect" title="Neurological">neurological</a> disorder such as a <a href="Migraine" title="Migraine">migraine</a> headache or an <a href="Epileptic_seizure" class="mw-redirect" title="Epileptic seizure">epileptic seizure</a>, where prodrome symptoms may include <a href="Euphoria" title="Euphoria">euphoria</a> or other changes in <a href="Mood_(psychology)" title="Mood (psychology)">mood</a>, <a href="Insomnia" title="Insomnia">insomnia</a>, <a href="Abdominal_aura" title="Abdominal aura">abdominal sensations</a>, disorientation, <a href="Aphasia" title="Aphasia">aphasia</a>, or <a href="Photophobia" title="Photophobia">photosensitivity</a>. Such a prodrome occurs on a scale of days to an hour before the episode, where an <a href="Aura_(symptom)" title="Aura (symptom)">aura</a> occurs more immediate to it.<a href="#cite_note-3">[3]</a>

<a href="Pre-labor" title="Pre-labor">Prodromal labour</a>, mistakenly called "false labour," refers to the early signs before labour starts.<a href="#cite_note-APA-4">[4]</a>

<div class="mw-heading mw-heading2"><h2 id="In_mental_health">In mental health</h2></div>

The prodrome is a period during which an individual experiences some <a href="Symptom" class="mw-redirect" title="Symptom">symptoms</a> and/or a change in functioning, which can signal the impending onset of a mental health disorder.<a href="#cite_note-5">[5]</a> It is otherwise known as the prodromal phase when referring to the <a href="Subsyndromal" class="mw-redirect" title="Subsyndromal">subsyndromal</a> stage or the early <a href="Abnormality_(behavior)" title="Abnormality (behavior)">abnormalities</a> in behavior, mood, and/or cognition before illness onset.<a href="#cite_note-6">[6]</a> Early detection of the prodrome can create an opportunity to administer appropriate early interventions quickly to try to delay or decrease the intensity of subsequent symptoms.<a href="#cite_note-7">[7]</a>

<div class="mw-heading mw-heading3"><h3 id="Schizophrenia">Schizophrenia</h3></div>

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</style><div role="note" class="hatnote navigation-not-searchable">See also: <a href="Schizophrenia#Onset" title="Schizophrenia">Schizophrenia § Onset</a></div>

<a href="Schizophrenia" title="Schizophrenia">Schizophrenia</a> was the first disorder for which a prodromal stage was described.<a href="#cite_note-:0-8">[8]</a> People who go on to develop schizophrenia commonly experience non-specific negative symptoms such as <a href="Depression_(mood)" title="Depression (mood)">depression</a>, <a href="Anxiety" title="Anxiety">anxiety</a>, and <a href="Social_isolation" title="Social isolation">social isolation</a>.<a href="#cite_note-:0-8">[8]</a> This is often followed by the emergence of attenuated <a href="Positive_symptoms" class="mw-redirect" title="Positive symptoms">positive symptoms</a> such as problems with communication, perception, and unusual thoughts that do not rise to the level of <a href="Psychosis" title="Psychosis">psychosis</a>.<a href="#cite_note-:0-8">[8]</a> Closer to the onset of psychosis, people often exhibit more serious symptoms like pre-<a href="Delusion" title="Delusion">delusional</a> unusual thoughts, pre-<a href="Hallucination" title="Hallucination">hallucinatory</a> perceptual abnormalities or pre-thought disordered speech disturbances.<a href="#cite_note-:0-8">[8]</a> As positive symptoms become more severe, in combination with <a href="Negative_symptoms" class="mw-redirect" title="Negative symptoms">negative symptoms</a> that may have begun earlier, the individual may meet the diagnostic criteria for schizophrenia.<a href="#cite_note-:1-9">[9]</a> Although a majority of individuals who experience some of the symptoms of schizophrenia will never meet full diagnostic criteria, approximately 20–40% will eventually be diagnosed with schizophrenia.<a href="#cite_note-:2-10">[10]</a> One of the challenges of identifying and treating the prodrome is that it is difficult to predict who, among those with symptoms, are likely to meet full criteria later.<a href="#cite_note-11">[11]</a>

<div class="mw-heading mw-heading4"><h4 id="Duration">Duration</h4></div>

The prodromal phase in schizophrenia can last anywhere from several weeks to several years, and <a href="Comorbidity" title="Comorbidity">comorbid disorders</a>, such as <a href="Major_depressive_disorder" title="Major depressive disorder">major depressive disorder</a>, are common during this period.<a href="#cite_note-12">[12]</a>

<div class="mw-heading mw-heading4"><h4 id="Identification/assessments">Identification/assessments</h4></div>

<a href="Screening_(medicine)" title="Screening (medicine)">Screening</a> instruments include the Scale of Prodromal Symptoms<a href="#cite_note-13">[13]</a><a href="#cite_note-Miller2003-14">[14]</a> and the PROD-screen.<a href="#cite_note-15">[15]</a><a href="#cite_note-16">[16]</a>

<a href="Medical_signs" class="mw-redirect" title="Medical signs">Signs</a> and symptoms of the prodrome to schizophrenia can be assessed more fully using <a href="Structured_interview" title="Structured interview">structured interviews</a>. For example, the Structured Interview for Prodromal Syndromes,<a href="#cite_note-17">[17]</a><a href="#cite_note-Miller2003-14">[14]</a> and the Comprehensive Assessment of At Risk Mental States (CAARMS)<a href="#cite_note-18">[18]</a> are both valid and reliable methods for identifying individuals likely experiencing the prodrome to schizophrenia or related <a href="Spectrum_disorder#Psychosis" title="Spectrum disorder">psychotic-spectrum disorders</a>.

There are ongoing research efforts to develop tools for early detection of at-risk individuals. This includes development of risk calculators<a href="#cite_note-19">[19]</a> and methods for large-scale population screening.<a href="#cite_note-20">[20]</a>

<div class="mw-heading mw-heading4"><h4 id="Interventions">Interventions</h4></div>

Describing the schizophrenia prodrome has been useful in promoting <a href="Early_intervention_in_psychosis" title="Early intervention in psychosis">early intervention</a>. Although not all people who are experiencing symptoms consistent with the prodrome will develop schizophrenia, <a href="Randomized_controlled_trial" title="Randomized controlled trial">randomized controlled trials</a> suggest that intervening with medication and/or <a href="Psychotherapy" title="Psychotherapy">psychotherapy</a> can improve outcomes.<a href="#cite_note-:2-10">[10]</a> Interventions with evidence of <a href="Efficacy_(pharmacology)" class="mw-redirect" title="Efficacy (pharmacology)">efficacy</a> include <a href="Antipsychotic" title="Antipsychotic">antipsychotic</a> and <a href="Antidepressant" title="Antidepressant">antidepressant</a> medications, which can delay conversion to psychosis and improve symptoms, although prolonged exposure to antipsychotics has been associated with adverse effects including <a href="Tardive_dyskinesia" title="Tardive dyskinesia">tardive dyskinesia</a>, an irreversible neurological motor disorder.<a href="#cite_note-:2-10">[10]</a> Psychotherapy for individuals and families can also improve functioning and <a href="Symptomatology" class="mw-redirect" title="Symptomatology">symptomatology</a>; specifically <a href="Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">cognitive behavioral therapy (CBT)</a> helps improve <a href="Coping_strategies" class="mw-redirect" title="Coping strategies">coping strategies</a> to decrease positive psychosis symptoms.<a href="#cite_note-:2-10">[10]</a> Additionally, <a href="Omega-3_fatty_acid" class="mw-redirect" title="Omega-3 fatty acid">omega-3 fish oil supplements</a> may help reduce prodromal symptoms.<a href="#cite_note-:2-10">[10]</a> Current guidelines suggest that individuals who are at "high risk" for developing schizophrenia should be monitored for at least one to two years while receiving psychotherapy and medication, as needed, to treat their symptoms.<a href="#cite_note-21">[21]</a>

<div class="mw-heading mw-heading3"><h3 id="Bipolar_disorder">Bipolar disorder</h3></div>

<div class="mw-heading mw-heading4"><h4 id="Symptomology">Symptomology</h4></div>

There is also growing evidence that there is a prodromal phase before the onset of <a href="Bipolar_disorder" title="Bipolar disorder">bipolar disorder</a>.<a href="#cite_note-:3-22">[22]</a> Although a majority of individuals with bipolar disorder report experiencing some symptoms preceding the full onset of their illness, the prodrome has not yet been described systematically. Descriptive reports of bipolar prodrome symptoms vary and often focus on nonspecific symptoms of <a href="Psychopathology" title="Psychopathology">psychopathology</a>, making identification of the prodromal phase difficult. The most commonly observed symptoms are too much energy, elated or depressed mood, and alterations in sleep patterns.<a href="#cite_note-:4-23">[23]</a> There are no prospective studies of the prodrome to bipolar disorder, but in the Longitudinal Assessment of Manic Symptoms (LAMS) study, which followed youth with elevated symptoms of <a href="Mania" title="Mania">mania</a> for ten years,<a href="#cite_note-24">[24]</a> approximately 23% of the sample met the bipolar criteria at the baseline and 13% of which did not meet the criteria at baseline eventually were diagnosed with bipolar disorder.<a href="#cite_note-25">[25]</a>

<div class="mw-heading mw-heading4"><h4 id="Duration_2">Duration</h4></div>

The reported duration of the prodrome to bipolar disorder varies widely (mean = 27.1 ± 23 months);<a href="#cite_note-:4-23">[23]</a> for most people, evidence suggests that the prodromal phase is likely to be long enough to allow for intervention.<a href="#cite_note-26">[26]</a>

<div class="mw-heading mw-heading4"><h4 id="Identification/assessments_2">Identification/assessments</h4></div>

Symptoms consistent with the prodrome to bipolar disorder can be identified through <a href="Semi-structured_interview" title="Semi-structured interview">semi-structured interviews</a> such as The Bipolar Prodrome Symptom Interview and Scale-Prospective (BPSS-P),<a href="#cite_note-27">[27]</a> and the Semi-structured Interview for Mood Swings<a href="#cite_note-28">[28]</a> and <a href="Symptom_Checklists_%22O%22_and_%22S%22" title="Symptom Checklists "O" and "S"">symptom checklists</a> like the <a href="Young_Mania_Rating_Scale" title="Young Mania Rating Scale">Young Mania Rating Scale (YMRS)</a><a href="#cite_note-29">[29]</a> and the <a href="Hamilton_Rating_Scale_for_Depression" title="Hamilton Rating Scale for Depression">Hamilton Depression Scale (HAM-D)</a>.<a href="#cite_note-30">[30]</a><a href="#cite_note-:4-23">[23]</a><a href="#cite_note-:3-22">[22]</a>

<div class="mw-heading mw-heading4"><h4 id="Interventions_2">Interventions</h4></div>

Early intervention is associated with better outcomes for people with prodromal symptoms of bipolar disorder. Interventions with some evidence of efficacy include medication (e.g. <a href="Mood_stabilizer" title="Mood stabilizer">mood stabilizers</a>, <a href="Atypical_antipsychotic" title="Atypical antipsychotic">atypical antipsychotics</a>) and psychotherapy. Specifically, <a href="Family_therapy" title="Family therapy">family-focused therapy</a> improves <a href="Emotion_regulation" class="mw-redirect" title="Emotion regulation">emotion regulation</a> and enhances functioning in both adults and adolescents.<a href="#cite_note-31">[31]</a> <a href="Interpersonal_and_social_rhythm_therapy" title="Interpersonal and social rhythm therapy">Interpersonal and Social Rhythm Therapy (IPSRT)</a> may be beneficial for youth at risk of developing the disease by helping to stabilize their sleep and <a href="Circadian_rhythm" title="Circadian rhythm">circadian</a> patterns.<a href="#cite_note-32">[32]</a> <a href="Psychoeducation" title="Psychoeducation">Psychoeducational Psychotherapy</a> (PEP) may be protective in individuals at risk of developing bipolar disorder and are associated with a four-fold reduction in risk for conversion to bipolar disorder.<a href="#cite_note-:5-33">[33]</a> This research needs to be explored further, however, it is currently thought to produce improvements in decreased stress due to <a href="Social_support" title="Social support">social support</a> and improved functioning through the skills developed in PEP. PEP can prove especially beneficial for individuals presenting transitional mania symptoms as it can assist caregivers in recognizing prodromal mania symptoms and knowing the next steps towards early intervention.<a href="#cite_note-:5-33">[33]</a> The key goals of this type of therapy are to provide education about <a href="Mood_disorder" title="Mood disorder">mood disorders</a> and treatments, social support, and to build skills in symptom management, emotion regulation, and problem-solving and communication. This research is in its infancy, further investigations will be necessary to determine which methods lead to the best outcomes and for whom.<a href="#cite_note-34">[34]</a>

<div class="mw-heading mw-heading2"><h2 id="In_neurological_conditions">In neurological conditions</h2></div>

<div class="mw-heading mw-heading3"><h3 id="Neurodegenerative_diseases">Neurodegenerative diseases</h3></div>

Several <a href="Neurodegeneration" class="mw-redirect" title="Neurodegeneration">neurodegenerative</a> diseases have a prodromal phase. Early impairments in behavior, personality and language may be detected in <a href="Alzheimer's_disease" title="Alzheimer's disease">Alzheimer's disease</a>.<a href="#cite_note-35">[35]</a> In <a href="Dementia_with_Lewy_bodies" title="Dementia with Lewy bodies">dementia with Lewy bodies</a>, there is an identifiable set of early signs and symptoms that can appear 15 years or more before <a href="Dementia" title="Dementia">dementia</a> develops.<a href="#cite_note-36">[36]</a> The earliest symptoms are <a href="Constipation" title="Constipation">constipation</a> and <a href="Dizziness" title="Dizziness">dizziness</a> from <a href="Dysautonomia" title="Dysautonomia">autonomic dysfunction</a>, <a href="Hyposmia" title="Hyposmia">hyposmia</a> (reduced ability to smell), visual hallucinations, and <a href="Rapid_eye_movement_sleep_behavior_disorder" title="Rapid eye movement sleep behavior disorder">rapid eye movement sleep behavior disorder</a> (RBD).<a href="#cite_note-37">[37]</a> RBD may appear years or decades before other symptoms.<a href="#cite_note-38">[38]</a> In <a href="Parkinson's_disease" title="Parkinson's disease">Parkinson's disease</a> the <a href="Anosmia" title="Anosmia">loss of sense of smell</a> may aid in earlier diagnosis.<a href="#cite_note-39">[39]</a> <a href="Multiple_sclerosis" title="Multiple sclerosis">Multiple sclerosis</a> may have a prodromal phase.<a href="#cite_note-Makhani2021Prodrome-40">[40]</a><a href="#cite_note-Marrie2019_Prodrome-41">[41]</a>

<div class="mw-heading mw-heading3"><h3 id="Migraine">Migraine</h3></div>

The <a href="Migraine#Prodrome_phase" title="Migraine">prodromal phase of migraine</a> is not always present, and varies from individual to individual, but can include ocular disturbances such as shimmering lights with reduced vision, altered mood, irritability, <a href="Clinical_depression" class="mw-redirect" title="Clinical depression">depression</a> or <a href="Euphoria_(emotion)" class="mw-redirect" title="Euphoria (emotion)">euphoria</a>, <a href="Fatigue_(physical)" class="mw-redirect" title="Fatigue (physical)">fatigue</a>, <a href="Yawning" class="mw-redirect" title="Yawning">yawning</a>, excessive sleepiness, craving for certain food (e.g. <a href="Chocolate" title="Chocolate">chocolate</a>), stiff muscles (especially in the neck), hot ears, constipation or diarrhea, increased urination, and other visceral symptoms.<a href="#cite_note-pmid15447695-42">[42]</a>

<ul><li><a href="Apophenia" title="Apophenia">Apophenia</a></li>

<li><a href="Postdrome" title="Postdrome">Postdrome</a></li></ul>

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

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</style><cite id="CITEREFOliwenstein2004" class="citation book cs1">Oliwenstein, Lori (2004). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=3LUqIqfwY4gC&pg=PA348">Psychology Today Taming Bipolar Disorder</a>. Penguin. p. 348. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-1-4406-9631-2</bdi>.</cite>

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<li id="cite_note-2"><a href="#cite_ref-2">^</a> <cite class="citation book cs1"><a rel="nofollow" class="external text" href="http://medical-dictionary.thefreedictionary.com/prodrome">Mosby's Medical Dictionary</a> (8th ed.). Elsevier. 2009. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>9780323049375</bdi>.</cite>

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<li id="cite_note-3"><a href="#cite_ref-3">^</a> <cite id="CITEREFKelman2004" class="citation journal cs1">Kelman, Leslie (2004). <a rel="nofollow" class="external text" href="https://headachejournal.onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.2004.04168.x">"The Premonitory Symptoms (Prodrome): A Tertiary Care Study of 893 Migraineurs"</a>. Headache: The Journal of Head and Face Pain. 44 (9): 865–872. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1526-4610.2004.04168.x">10.1111/j.1526-4610.2004.04168.x</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0017-8748">0017-8748</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15447695">15447695</a> – via Headache Journal.</cite>

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<li id="cite_note-APA-4"><a href="#cite_ref-APA_4-0">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://americanpregnancy.org/labor-and-birth/prodromal-labor/">"Prodromal Labor"</a>. American Pregnancy Association. 8 June 2018.</cite>

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<li id="cite_note-5"><a href="#cite_ref-5">^</a> <cite id="CITEREFZeschelCorrellHaussleiterKrüger-Özgürdal2013" class="citation journal cs1">Zeschel E, Correll CU, Haussleiter IS, Krüger-Özgürdal S, Leopold K, Pfennig A, et al. (November 2013). "The bipolar disorder prodrome revisited: Is there a symptomatic pattern?". Journal of Affective Disorders. 151 (2): 551–60. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jad.2013.06.043">10.1016/j.jad.2013.06.043</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23932736">23932736</a>.</cite>

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<li id="cite_note-6"><a href="#cite_ref-6">^</a> <cite id="CITEREFBauerJuckelCorrellLeopold2008" class="citation journal cs1 cs1-prop-long-vol">Bauer M, Juckel G, Correll CU, Leopold K, Pfennig A (November 2008). "Diagnosis and treatment in the early illness phase of bipolar disorders". European Archives of Psychiatry and Clinical Neuroscience. 258 Suppl 5 (S5): 50–4. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs00406-008-5009-z">10.1007/s00406-008-5009-z</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18985295">18985295</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:529703">529703</a>.</cite>

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</ol></div>

<div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div>

<ul><li> Learning materials related to <a href="https://en.wikiversity.org/wiki/Evidence_based_assessment/Schizophrenia_(disorder_portfolio)" class="extiw external" title="v:Evidence based assessment/Schizophrenia (disorder portfolio)">Evidence based assessment/Schizophrenia (disorder portfolio)</a> at Wikiversity</li>

<li> Learning materials related to <a href="https://en.wikiversity.org/wiki/Evidence_based_assessment/Bipolar_disorder_in_youth_(assessment_portfolio)" class="extiw external" title="v:Evidence based assessment/Bipolar disorder in youth (assessment portfolio)">Evidence based assessment/Bipolar disorder in youth (assessment portfolio)</a> at Wikiversity</li>

<li> Learning materials related to <a href="https://en.wikiversity.org/wiki/Evidence_based_assessment/Bipolar_disorder_in_adults_(assessment_portfolio)" class="extiw external" title="v:Evidence based assessment/Bipolar disorder in adults (assessment portfolio)">Evidence based assessment/Bipolar disorder in adults (assessment portfolio)</a> at Wikiversity</li></ul>

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</style><div id="Psychiatry265" style="font-size:114%;margin:0 4em"><a href="Psychiatry" title="Psychiatry">Psychiatry</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Subspecialties</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Addiction_psychiatry" title="Addiction psychiatry">Addiction psychiatry</a></li>

<li><a href="Biological_psychiatry" title="Biological psychiatry">Biological psychiatry</a></li>

<li><a href="Child_and_adolescent_psychiatry" title="Child and adolescent psychiatry">Child and adolescent psychiatry</a></li>

<li><a href="Cognitive_neuropsychiatry" title="Cognitive neuropsychiatry">Cognitive neuropsychiatry</a></li>

<li><a href="Cross-cultural_psychiatry" title="Cross-cultural psychiatry">Cross-cultural psychiatry</a></li>

<li><a href="Developmental_disability" title="Developmental disability">Developmental disability</a></li>

<li><a href="Descriptive_psychiatry" title="Descriptive psychiatry">Descriptive psychiatry</a></li>

<li><a href="Eating_disorder" title="Eating disorder">Eating disorder</a></li>

<li><a href="Emergency_psychiatry" title="Emergency psychiatry">Emergency psychiatry</a></li>

<li><a href="Forensic_psychiatry" title="Forensic psychiatry">Forensic psychiatry</a></li>

<li><a href="Geriatric_psychiatry" title="Geriatric psychiatry">Geriatric psychiatry</a></li>

<li><a href="Immuno-psychiatry" title="Immuno-psychiatry">Immuno-psychiatry</a></li>

<li><a href="Liaison_psychiatry" title="Liaison psychiatry">Liaison psychiatry</a></li>

<li><a href="Military_psychiatry" title="Military psychiatry">Military psychiatry</a></li>

<li><a href="Nutritional_psychiatry" title="Nutritional psychiatry">Nutritional psychiatry</a></li>

<li><a href="Narcology" title="Narcology">Narcology</a></li>

<li><a href="Neuropsychiatry" title="Neuropsychiatry">Neuropsychiatry</a></li>

<li><a href="Palliative_medicine" class="mw-redirect" title="Palliative medicine">Palliative medicine</a></li>

<li><a href="Pain_management" title="Pain management">Pain medicine</a></li>

<li><a href="Psychotherapy" title="Psychotherapy">Psychotherapy</a></li>

<li><a href="Sleep_medicine" title="Sleep medicine">Sleep medicine</a></li>

<li><a href="Telepsychiatry" title="Telepsychiatry">Telepsychiatry</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Organizations</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="American_Academy_of_Child_and_Adolescent_Psychiatry" title="American Academy of Child and Adolescent Psychiatry">American Academy of Child and Adolescent Psychiatry</a></li>

<li><a href="American_Board_of_Psychiatry_and_Neurology" title="American Board of Psychiatry and Neurology">American Board of Psychiatry and Neurology</a></li>

<li><a href="American_Neuropsychiatric_Association" title="American Neuropsychiatric Association">American Neuropsychiatric Association</a></li>

<li><a href="American_Psychiatric_Association" title="American Psychiatric Association">American Psychiatric Association</a></li>

<li><a href="British_Neuropsychiatry_Association" title="British Neuropsychiatry Association">British Neuropsychiatry Association</a></li>

<li><a href="Campaign_Against_Psychiatric_Abuse" title="Campaign Against Psychiatric Abuse">Campaign Against Psychiatric Abuse</a></li>

<li><a href="Chinese_Society_of_Psychiatry" title="Chinese Society of Psychiatry">Chinese Society of Psychiatry</a></li>

<li><a href="Democratic_Psychiatry" title="Democratic Psychiatry">Democratic Psychiatry</a></li>

<li><a href="European_Psychiatric_Association" title="European Psychiatric Association">European Psychiatric Association</a></li>

<li><a href="Global_Initiative_on_Psychiatry" title="Global Initiative on Psychiatry">Global Initiative on Psychiatry</a></li>

<li><a href="Hong_Kong_College_of_Psychiatrists" title="Hong Kong College of Psychiatrists">Hong Kong College of Psychiatrists</a></li>

<li><a href="Independent_Psychiatric_Association_of_Russia" title="Independent Psychiatric Association of Russia">Independent Psychiatric Association of Russia</a></li>

<li><a href="Indian_Psychiatric_Society" title="Indian Psychiatric Society">Indian Psychiatric Society</a></li>

<li><a href="National_Institute_of_Mental_Health" title="National Institute of Mental Health">National Institute of Mental Health</a></li>

<li><a href="Philadelphia_Association" title="Philadelphia Association">Philadelphia Association</a></li>

<li><a href="Royal_Australian_and_New_Zealand_College_of_Psychiatrists" title="Royal Australian and New Zealand College of Psychiatrists">Royal Australian and New Zealand College of Psychiatrists</a></li>

<li><a href="Royal_College_of_Psychiatrists" title="Royal College of Psychiatrists">Royal College of Psychiatrists</a></li>

<li><a href="Taiwanese_Society_of_Child_and_Adolescent_Psychiatry" title="Taiwanese Society of Child and Adolescent Psychiatry">Taiwanese Society of Child and Adolescent Psychiatry</a></li>

<li><a href="Working_Commission_to_Investigate_the_Use_of_Psychiatry_for_Political_Purposes" title="Working Commission to Investigate the Use of Psychiatry for Political Purposes">Working Commission to Investigate the Use of Psychiatry for Political Purposes</a></li>

<li><a href="World_Psychiatric_Association" title="World Psychiatric Association">World Psychiatric Association</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Behavioral_medicine" title="Behavioral medicine">Behavioral medicine</a></li>

<li><a href="Clinical_neuroscience" title="Clinical neuroscience">Clinical neuroscience</a></li>

<li><a href="Controversies_about_psychiatry" title="Controversies about psychiatry">Controversies about psychiatry</a>

<ul><li><a href="Anti-psychiatry" title="Anti-psychiatry">Anti-psychiatry</a></li>

<li><a href="Biopsychiatry_controversy" title="Biopsychiatry controversy">Biopsychiatry controversy</a></li>

<li><a href="Electroconvulsive_therapy" title="Electroconvulsive therapy">Electroconvulsive therapy</a></li>

<li><a href="Insulin_shock_therapy" title="Insulin shock therapy">Insulin shock therapy</a></li>

<li><a href="Political_abuse_of_psychiatry" title="Political abuse of psychiatry">Political abuse of psychiatry</a></li>

<li><a href="Psychiatric_survivors_movement" title="Psychiatric survivors movement">Psychiatric survivors movement</a></li></ul></li>

<li><a href="Imaging_genetics" title="Imaging genetics">Imaging genetics</a></li>

<li><a href="Neuroimaging" title="Neuroimaging">Neuroimaging</a></li>

<li><a href="Neurophysiology" title="Neurophysiology">Neurophysiology</a></li>

<li><a href="Pentylenetetrazol" title="Pentylenetetrazol">Pentylenetetrazol</a></li>

<li><a href="Philosophy_of_psychiatry" title="Philosophy of psychiatry">Philosophy of psychiatry</a></li>

<li><a href="Psychiatric_epidemiology" title="Psychiatric epidemiology">Psychiatric epidemiology</a></li>

<li><a href="Psychiatric_genetics" title="Psychiatric genetics">Psychiatric genetics</a></li>

<li><a href="Psychiatric_hospital" title="Psychiatric hospital">Psychiatric hospital</a></li>

<li><a href="Psychiatrist" title="Psychiatrist">Psychiatrist</a></li>

<li><a href="Psychoanalysis" title="Psychoanalysis">Psychoanalysis</a></li>

<li><a href="Psycho-oncology" title="Psycho-oncology">Psycho-oncology</a></li>

<li><a href="Psychopharmacology" title="Psychopharmacology">Psychopharmacology</a></li>

<li><a href="Psychosomatic_medicine" title="Psychosomatic medicine">Psychosomatic medicine</a></li>

<li><a href="Psychosurgery" title="Psychosurgery">Psychosurgery</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Lists</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="List_of_counseling_topics" class="mw-redirect" title="List of counseling topics">Counseling topics</a></li>

<li><a href="List_of_neurological_conditions_and_disorders" title="List of neurological conditions and disorders">Neurological conditions and disorders</a></li>

<li><a href="List_of_psychiatric_medications" title="List of psychiatric medications">Psychiatric medications</a>

<ul><li><a href="List_of_psychiatric_medications_by_condition_treated" title="List of psychiatric medications by condition treated">by condition treated</a></li></ul></li>

<li><a href="Outline_of_the_psychiatric_survivors_movement" title="Outline of the psychiatric survivors movement">Psychiatric survivors movement</a></li>

<li><a href="List_of_psychiatrists" title="List of psychiatrists">Psychiatrists</a></li>

<li><a href="List_of_psychotherapies" title="List of psychotherapies">Psychotherapies</a></li></ul>

</div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div>

<ul><li> <a href="Portal%3APsychiatry" title="Portal:Psychiatry">Portal</a></li>

<li> <a href="Outline_of_psychiatry" title="Outline of psychiatry">Outline</a></li></ul>

</div></td></tr></tbody></table></div>

<div class="navbox-styles"></div><div role="navigation" class="navbox" aria-labelledby="Mood_disorder226" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Mood_disorder226" style="font-size:114%;margin:0 4em"><a href="Mood_disorder" title="Mood disorder">Mood disorder</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Affective_spectrum" title="Affective spectrum">Spectrum</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Bipolar_disorder" title="Bipolar disorder">Bipolar disorder</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Bipolar_I_disorder" title="Bipolar I disorder">Bipolar I</a></li>

<li><a href="Bipolar_II_disorder" title="Bipolar II disorder">Bipolar II</a></li>

<li><a href="Cyclothymia" title="Cyclothymia">Cyclothymia</a></li>

<li><a href="Bipolar_disorder_not_otherwise_specified" title="Bipolar disorder not otherwise specified">Bipolar NOS</a></li>

<li><a href="Bipolar_disorder_in_children" title="Bipolar disorder in children">Childhood</a></li>

<li><a href="Hypomania" title="Hypomania">Hypomania</a></li>

<li><a href="Mania" title="Mania">Mania</a></li>

<li><a href="Mixed_affective_state" title="Mixed affective state">Mixed affective state</a></li>

<li><a href="Rapid_cycling" class="mw-redirect" title="Rapid cycling">Rapid cycling</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Depression_(mood)" title="Depression (mood)">Depression</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Major_depressive_disorder" title="Major depressive disorder">Major depressive disorder</a></li>

<li><a href="Dysthymia" title="Dysthymia">Dysthymia</a></li>

<li><a href="Seasonal_affective_disorder" title="Seasonal affective disorder">Seasonal affective disorder</a></li>

<li><a href="Atypical_depression" title="Atypical depression">Atypical depression</a></li>

<li><a href="Melancholic_depression" class="mw-redirect" title="Melancholic depression">Melancholic depression</a></li>

<li><a href="Major_depressive_episode" title="Major depressive episode">Major depressive episode</a></li>

<li><a href="Depression_in_childhood_and_adolescence" title="Depression in childhood and adolescence">Depression in childhood and adolescence</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Comorbidities</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Schizoaffective_disorder" title="Schizoaffective disorder">Schizoaffective disorder</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Symptom" class="mw-redirect" title="Symptom">Symptoms</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Delusion" title="Delusion">Delusion</a></li>

<li><a href="Depression_(differential_diagnoses)" class="mw-redirect" title="Depression (differential diagnoses)">Depression (differential diagnoses)</a></li>

<li><a href="Emotional_dysregulation" title="Emotional dysregulation">Emotional dysregulation</a>

<ul><li><a href="Anhedonia" title="Anhedonia">Anhedonia</a></li>

<li><a href="Dysphoria" title="Dysphoria">Dysphoria</a></li>

<li><a href="Suicidal_ideation" title="Suicidal ideation">Suicidal ideation</a></li></ul></li>

<li><a href="Episodic_memory" title="Episodic memory">Episodic memory</a></li>

<li><a href="Hallucination" title="Hallucination">Hallucination</a></li>

<li><a href="Mood_swing" title="Mood swing">Mood swing</a></li>

<li><a href="Sleep_disorder" title="Sleep disorder">Sleep disorder</a>

<ul><li><a href="Hypersomnia" title="Hypersomnia">Hypersomnia</a></li>

<li><a href="Insomnia" title="Insomnia">Insomnia</a></li></ul></li>

<li><a href="Psychosis" title="Psychosis">Psychosis</a></li>

<li><a href="Psychotic_depression" title="Psychotic depression">Psychotic depression</a></li>

<li><a href="Racing_thoughts" title="Racing thoughts">Racing thoughts</a></li>

<li><a href="Reduced_affect_display" title="Reduced affect display">Reduced affect display</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="List_of_diagnostic_classification_and_rating_scales_used_in_psychiatry" title="List of diagnostic classification and rating scales used in psychiatry">Diagnosis</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Bipolar_Spectrum_Diagnostic_Scale" title="Bipolar Spectrum Diagnostic Scale">Bipolar Spectrum Diagnostic Scale</a></li>

<li><a href="Child_Mania_Rating_Scale" title="Child Mania Rating Scale">Child Mania Rating Scale</a></li>

<li><a href="General_Behavior_Inventory" title="General Behavior Inventory">General Behavior Inventory</a></li>

<li><a href="Hypomania_Checklist" title="Hypomania Checklist">Hypomania Checklist</a></li>

<li><a href="Mood_Disorder_Questionnaire" title="Mood Disorder Questionnaire">Mood Disorder Questionnaire</a></li>

<li><a href="Rating_scales_for_depression" title="Rating scales for depression">Rating scales for depression</a></li>

<li><a href="Young_Mania_Rating_Scale" title="Young Mania Rating Scale">Young Mania Rating Scale</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Treatment_of_bipolar_disorder" title="Treatment of bipolar disorder">Treatment</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Anticonvulsant" title="Anticonvulsant">Anticonvulsants</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Carbamazepine" title="Carbamazepine">Carbamazepine</a></li>

<li><a href="Lamotrigine" title="Lamotrigine">Lamotrigine</a></li>

<li><a href="Oxcarbazepine" title="Oxcarbazepine">Oxcarbazepine</a></li>

<li><a href="Valproate" title="Valproate">Valproate</a>

<ul><li><a href="Sodium_valproate" class="mw-redirect" title="Sodium valproate">Sodium valproate</a></li>

<li><a href="Valproate_semisodium" class="mw-redirect" title="Valproate semisodium">Valproate semisodium</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Sympathomimetic_drug" title="Sympathomimetic drug">Sympathomimetics</a>, <a href="Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">SSRIs</a> and similar</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Bupropion" title="Bupropion">Bupropion</a></li>

<li><a href="Dextroamphetamine" title="Dextroamphetamine">Dextroamphetamine</a></li>

<li><a href="Escitalopram" title="Escitalopram">Escitalopram</a></li>

<li><a href="Fluoxetine" title="Fluoxetine">Fluoxetine</a></li>

<li><a href="Methylphenidate" title="Methylphenidate">Methylphenidate</a></li>

<li><a href="Sertraline" title="Sertraline">Sertraline</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other <a href="Mood_stabilizer" title="Mood stabilizer">mood stabilizers</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Antipsychotic" title="Antipsychotic">Antipsychotics</a></li>

<li><a href="Atypical_antipsychotic" title="Atypical antipsychotic">Atypical antipsychotics</a></li>

<li><a href="Lithium_(medication)" title="Lithium (medication)">Lithium</a>

<ul><li><a href="Lithium_carbonate" title="Lithium carbonate">Lithium carbonate</a></li>

<li><a href="Lithium_citrate" title="Lithium citrate">Lithium citrate</a></li>

<li><a href="Lithium_sulfate" title="Lithium sulfate">Lithium sulfate</a></li>

<li><a href="Lithium_toxicity" title="Lithium toxicity">Lithium toxicity</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Non-pharmaceutical</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Clinical_psychology" title="Clinical psychology">Clinical psychology</a></li>

<li><a href="Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">Cognitive behavioral therapy</a></li>

<li><a href="Dialectical_behavior_therapy" title="Dialectical behavior therapy">Dialectical behavior therapy</a></li>

<li><a href="Electroconvulsive_therapy" title="Electroconvulsive therapy">Electroconvulsive therapy</a></li>

<li><a href="Involuntary_commitment" title="Involuntary commitment">Involuntary commitment</a></li>

<li><a href="Light_therapy" title="Light therapy">Light therapy</a></li>

<li><a href="Psychotherapy" title="Psychotherapy">Psychotherapy</a></li>

<li><a href="Transcranial_magnetic_stimulation" title="Transcranial magnetic stimulation">Transcranial magnetic stimulation</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="History_of_bipolar_disorder" title="History of bipolar disorder">History</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Emil_Kraepelin" title="Emil Kraepelin">Emil Kraepelin</a></li>

<li><a href="Frederick_K._Goodwin" title="Frederick K. Goodwin">Frederick K. Goodwin</a></li>

<li><a href="Karl_Leonhard" title="Karl Leonhard">Karl Leonhard</a></li>

<li><a href="Kay_Redfield_Jamison" title="Kay Redfield Jamison">Kay Redfield Jamison</a></li>

<li><a href="Mogens_Schou" title="Mogens Schou">Mogens Schou</a></li></ul>

</div></td></tr></tbody></table></div></div><div><div class="zim-footer">

This article is issued from <a class="external text" title="Last edited on 2025-07-12" href="https://en.wikipedia.org/wiki/?title=Prodrome&oldid=1300121495">Wikipedia</a>. The text is available under <a class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.en">Creative Commons Attribution-Share Alike 4.0</a> unless otherwise noted. Additional terms may apply for the media files.

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