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The Cochrane Library

Training to recognise the early signs of recurrence in schizophrenia


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The onset of schizophrenia usually occurs during adolescence or early adulthood. Diagnosis is predictive of an increased risk of suicide, impaired occupational and social functioning, and a heightened risk of physical illness. Most people with schizophrenia experience a cyclical pattern of illness with periods of acute psychotic episodes followed by stable periods of full or partial remission.

Training in early warning signs techniques encourages people to learn, detect and recognise the early warning signs of future illness. Studies indicate that noticing even small changes in signs and symptoms of schizophrenia can often predict future illness and relapse two to 10 weeks later. Early warning training may help to prevent or delay relapse, so reducing the chances of going into hospital.

A recent Cochrane Review compares the effectiveness of early warning signs interventions plus treatment as usual involving and not involving a psychological therapy on time to relapse, hospitalisation, functioning, negative and positive symptomatology. Thirty-four studies that randomised 3554 people satisfied criteria for inclusion.

Is training in early warning signs effective in reducing rates of relapse and re-hospitalisation?

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