'Schizophrenia postdrome': a study of low-level psychotic experience after remission of first-episode schizophrenia

Background: Despite remission being the primary objective following the first episode of schizophrenia, clinically stabilized patients nevertheless relapse. Aim: To assess the extent and fluctuation of low-level psychotic symptoms in patients who are in remission after first-episode schizophrenia and consider whether this is equivalent to symptomatology experienced by those at 'ultra high risk' (UHR) of developing first-episode psychosis. Methods: We examined the phenomenological characteristics of 11 patients who fulfilled international remission criteria using the Structured Interview for Prodromal Symptoms and compared this cohort with an UHR sample. Results: Remitted patients were experiencing attenuated positive symptoms (73%) and brief limited intermittent psychotic symptoms (18%), features that were similarly prevalent in the UHR group. There was no significant fluctuation in these low-level symptoms over the course of four interviews. Conclusions: Although further research is required in this novel field, such features could form the building blocks for better prediction of psychotic relapse.