What is the prodrome?

The “prodromal syndrome” is not a diagnosis, but the technical term used by mental health professionals to describe a specific group of symptoms that may precede the onset of a mental illness. For example, a runny-nose is often “prodromal” to (happening before) a cold, which means that a runny-nose may be a risk factor for developing this illness. However, not everyone who has a runny-nose goes on to develop a cold. In order to prevent measles from developing, you would try to get rid of your fever and take care of any other symptoms you might have.  At ADAPT, we focus on taking care of symptoms that may precede the onset of psychosis. This outlook involves following a series of symptoms, rather than burdening individuals and their families with changing and confusing diagnostic labels.

Psychosis affects between 1% and 3% of the population, and typically emerges between the ages of 15 and 30. The prodromal phase of psychosis may last anywhere from a couple of days to a couple of years. During this time, individuals experience symptoms of psychosis at mild or moderate levels of intensity, or for short periods of time. Individuals and their families may also notice changes in functioning, such as trouble with school or work and social withdrawal or anxiety.

It is important to note that just because an individual is “prodromal” does not mean that they will go on to develop psychosis. You would not assume that someone is inevitably developing measles simply because they have a fever. Likewise, you should not assume that someone will inevitably go on to develop psychosis simply because they are experiencing prodromal symptoms.

Signs and Symptoms

While each person’s prodrome is unique, there are some common themes to look out for. 

Early signs and symptoms can include any of the following:

Unusual Thinking

Confusion about what is real and what is imaginary

Suspiciousness or paranoid thinking

Feeling that your ideas are or behaviors are being controlled by outside forces

Unrealistic ideas of special identity or abilities

Preoccupation with the supernatural


Perceptual Disturbances

Sensitivity to sounds, easily distracted by background noises

Hearing things that other people don’t hear

Seeing things that others don’t see

Smelling, tasting, or feeling unusual sensations that other people don’t experience


Negative Symptoms

Wanting to spend more time alone

Not feeling motivated to do things

Trouble understanding conversations or written materials

Difficulty identifying and expressing emotions




Disorganized Symptoms

Trouble with attention

Neglect of personal hygiene

Laughing at odd or inappropriate times

Problems with communication

Vague, racing or slow speech, difficulty staying on track or getting to the point


Mood Symptoms

Sadness, emptiness, or irritability

Loss of interest or pleasure

Physical symptoms (tiredness, weight gain/loss, aches and pains)

Thoughts of death and/or suicide

Elevated mood: excitement, feeling high or “hyper” Racing thoughts

Distractibility, talkativeness

Increased activity


Inflated self-esteem or feelings of self-importance

Decreased need for sleep


Anxiety Symptoms

Constant fear or worry

Excessive social anxiety

Panic Attacks

Agoraphobia (fear of leaving home)



Impairment in Functioning

Decline in functioning

Problems in relationships with friends or family