Current psychiatric prevention strategies in Japan
The Japanese Society of Prevention in Psychiatric Disorders was established in 1996, and the first meeting was held in 1997. The scientific meeting is held annually and a Newsletter is published regularly.
Our project on early intervention among college students was begun in 1994. Either the Psychosis Proneness Scales (1994-1997) or the Schizotypal Personality Questionnaire (1998) was distributed to first year students who visited the Health Administration Center, University of Ryukyus, at the beginning of the academic year. From 1994-1998, a total of 9134 freshmen entered the University and 4565 out of 9134 (50%) freshmen received one of the screening tests mentioned above. Ninety eight freshmen who had scores above 2SD were interviewed by a psychiatrist. Among the 98 students there were 12 who were suspected to be in the prodromal state of schizophrenia (DSM-III R), 4 with borderline personality disorder (DSM-IV), 1 with schizotypal personality disorder (DSM-IV) and the remaining with other conditions requiring intervention. Thirty four students have been receiving counseling with the aim of preventing the development of full blown schizophrenia.
From our experience, we attempted hypothetical staging at the prodromal phase of schizophrenia. The basic concept is to regard schizophrenia as a process. "Stage 0" is the premorbid phase or phase before the prodromal phase. "Stage I" is the earlier phase of the prodromal phase, approximately less than 6 months or after the onset of psychosis. "Stage II" is the later phase of the prodromal phase, approximately 6 months or more after onset. "Stage III" is the psychotic phase. Each stage is roughly divided into "high risk" (H)" and "low risk (L)".
A case report
C. Ogura, H. Ohta, K. Hiramatsu, K. Yamamoto
Department of Neuropsychiatry, Faculty of Medecine
University of the Ryukyus
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