In medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

, a prodrome is an early symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...

 (or set of symptoms) that might indicate the start of a disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

 before specific symptoms occur. It is derived from the Greek word prodromos or precursor. Prodromes may be non-specific symptoms or, in a few instances, may clearly indicate a particular disease, such as the prodromal migraine aura.

For example fever, malaise
Malaise is a feeling of general discomfort or uneasiness, of being "out of sorts", often the first indication of an infection or other disease. Malaise is often defined in medicinal research as a "general feeling of being unwell"...

, headache and lack of appetite frequently occur in the prodrome of many infective disorders. A prodrome can be the precursor to the onset of a chronic neurological disorder such as migraine
Migraine is a chronic neurological disorder characterized by moderate to severe headaches, and nausea...

 or epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...

, where prodrome symptoms include euphoria, scotoma
A scotoma is an area of partial alteration in one's field of vision consisting of a partially diminished or entirely degenerated visual acuity which is surrounded by a field of normal - or relatively well-preserved - vision.Every normal mammalian eye has a scotoma in its field of vision, usually...

, disorientation, aphasia
Aphasia is an impairment of language ability. This class of language disorder ranges from having difficulty remembering words to being completely unable to speak, read, or write....

, or photosensitivity.

It also refers to the initial in vivo
In vivo
In vivo is experimentation using a whole, living organism as opposed to a partial or dead organism, or an in vitro controlled environment. Animal testing and clinical trials are two forms of in vivo research...

round of viral replication.

Prodromal labour
Pre-labor, also called "prodromal labor," consists of the early signs before labor starts. It is the body's preparation for real labor....

, mistakenly called "false labour," refers to the early signs before labour starts.

In schizophrenia

A prodrome for schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

 is the period of decreased functioning that is postulated to correlate with the onset of psychotic symptoms. The concept has been reconsidered as the pathways to emerging psychosis have been investigated since the mid-1990s. One example of the international paradigms aimed at researching the prodrome is the North American Prodrome Longitudinal Study (NAPLS). This study is concerned with brain development, hormones, and neuropsychological functions that may play a role in risk for and prevention of mental illness in young adulthood. The term at risk mental state
At risk mental state
At risk mental state is the term used to describe the clinical presentation of those considered at risk of developing psychosis or schizophrenia...

 is sometimes preferred, as a prodromal period cannot be confirmed unless the emergence of the condition has occurred. (also see early psychosis
Early intervention in psychosis
Early intervention in psychosis is a clinical approach to those experiencing symptoms of psychosis for the first time. It forms part of a new prevention paradigm for psychiatry and is leading to reform of mental health services, especially in the United Kingdom....


Prodrome, or psychosis risk syndrome as it is also known, is a proposed syndrome to be used the DSM-V
The next edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders , commonly called DSM-5 , is currently in consultation, planning and preparation...

(2013) of psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

. It is also defined as "the aura
Aura (symptom)
An aura is a perceptual disturbance experienced by some migraine sufferers before a migraine headache, and the telltale sensation experienced by some people with epilepsy before a seizure. It often manifests as the perception of a strange light, an unpleasant smell or confusing thoughts or...

 that precedes a psychotic break
Psychotic break
A psychotic break is a term used to describe an occasion of a person experiencing an episode of acute primary psychosis, either for the first time or after a significant period of relative asymptomaticity. Several types of psychoactive drugs have been shown to correlate with psychotic breaks...

 by up to two or three years." Patients with this condition "still have 'insight
Insight is the understanding of a specific cause and effect in a specific context. Insight can be used with several related meanings:*a piece of information...

' - a pivotal word in psychiatric literature, indicating that a patient can still recognize an altered worldview as a sign of illness
Illness is a state of poor health. Illness is sometimes considered another word for disease. Others maintain that fine distinctions exist...

, not revelation." Prodrome is also sometimes called "attenuated psychotic symptoms syndrome."

About one third of patients with prodrome are diagnosed with schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

 or other psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...

 in a few years. In the North American Prodrome Longitudinal Study, researchers found that 35 percent of "patients had a psychotic break within two and a half years of enrolling at a clinic." 65 percent "found that their symptoms passed or plateaued." A psychotic break is made statistically more likely (43 % vs. 35 %) if the patient abuses certain drugs
Drug abuse
Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts...


Prodromal phase of common diseases and conditions

  • Measles
    Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...

     - Marked by fever
    Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

    , rhinorrhea
    Rhinorrhea or rhinorrhoea is a condition where the nasal cavity is filled with a significant amount of mucous fluid. The condition, commonly known as "runny nose", occurs relatively frequently and is not usually considered dangerous. Rhinorrhea is a common symptom of allergies or certain diseases,...

    , and conjuctivitis.
  • Varicella
    Chickenpox or chicken pox is a highly contagious illness caused by primary infection with varicella zoster virus . It usually starts with vesicular skin rash mainly on the body and head rather than at the periphery and becomes itchy, raw pockmarks, which mostly heal without scarring...

     - May or may not feature a prodrome, but at least 37% of unvaccinated children who contract chickenpox do have at least a mild febrile prodrome.
  • Migraine - Not always present, and varies from individual to individual, but can include altered mood, irritability, depression
    Clinical depression
    Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...

     or euphoria
    Euphoria (emotion)
    Euphoria is medically recognized as a mental and emotional condition in which a person experiences intense feelings of well-being, elation, happiness, ecstasy, excitement and joy...

    , fatigue
    Fatigue (physical)
    Fatigue is a state of awareness describing a range of afflictions, usually associated with physical and/or mental weakness, though varying from a general state of lethargy to a specific work-induced burning sensation within one's muscles...

    , yawning, excessive sleepiness, craving for certain food (e.g. chocolate
    Chocolate is a raw or processed food produced from the seed of the tropical Theobroma cacao tree. Cacao has been cultivated for at least three millennia in Mexico, Central and South America. Its earliest documented use is around 1100 BC...

    ), stiff muscles (especially in the neck), hot ears, constipation or diarrhea, increased urination, and other visceral symptoms.
  • Herpes simplex
    Herpes simplex
    Herpes simplex is a viral disease caused by both Herpes simplex virus type 1 and type 2 . Infection with the herpes virus is categorized into one of several distinct disorders based on the site of infection. Oral herpes, the visible symptoms of which are colloquially called cold sores or fever...

     - Marked by tingling (paresthesia
    Paresthesia , spelled "paraesthesia" in British English, is a sensation of tingling, burning, pricking, or numbness of a person's skin with no apparent long-term physical effect. It is more generally known as the feeling of "pins and needles" or of a limb "falling asleep"...

    ), itching, and pain.
  • Diverticulitis
    Diverticulitis is a common digestive disease particularly found in the large intestine. Diverticulitis develops from diverticulosis, which involves the formation of pouches on the outside of the colon...

     - May worsen throughout the first day, as it starts out as small pains in the torso and/or mild diarrhea
    Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

    , and may slowly turn into vomiting and sharp pains in the lower left quadrant of the abdomen.
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