OBJECTIVE: The aim of this paper was to review the clinical and
conceptual implications of the studies investigating prodromal symptoms of
mania, depression, and panic disorder. METHOD: Twenty-four studies
specifically addressing the issue of prodromal symptoms in mood and anxiety
disorders were selected by computer search (Medline) and manual search of
Index Medicus and the psychiatric literature. RESULTS: Most of the studies
have described a prodromal phase in the development of mania, depression,
and panic attacks. CONCLUSIONS: The appearance of prodromal symptoms may
precede the full syndrome by weeks or months; if these symptoms are
detected, recurrences of affective disorders (bipolar illness, unipolar
depression, panic disorder) could be treated earlier and perhaps more
effectively. DSM-III has emphasized the traditional clinical syndromes and
cross-sectional descriptions. Appraisal of prodromal and residual phases
may complement this approach. The longitudinal study of prodromes, the
fully developed disorder, and residual states calls for an assessment of
personality, neurotic traits, and their interaction in the evolution of
affective disorders.
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