Prodrome Screening Self-Report Questionnaire
First of all, I'd like to introduce myself. My name is Brian Schulman and I am currently a medical student at the University of California, San Francisco (UCSF). I have a particular clinical and research interest in schizophrenia and am currently pursuing a Howard Hughes Medical Institute Research Fellowship to study aspects of the sense of self in schizophrenia using brain imaging techniques. Along with my colleague Dr. Demian Rose, who has already written some reviews on this site, I hope to bring you some summaries and critical analysis of recent research articles in this field.
Introductions, aside, I'll move right along to my first review:
Prodrome Screening Self-Report Questionnaire
Source: Schizophr Res. 2005 Nov 1;79(1):117-25.
Dr. Rachel Loewy, previously at UCLA and now at UCSF, and her former colleagues at UCLA have recently published an article in Schizophrenia Research demonstrating preliminary evidence supporting the use of a self-report screening questionnaire for individuals who may be at risk of developing psychosis. The researchers targeted individuals who may be in an early period of illness before full-blown psychosis develops. This period is known as the schizophrenia prodrome.
Studies on the prodromal phase are critical because research suggests that the earlier that schizophrenia is treated, the better the outcome. In the last few years, various sites have opened schizophrenia prodrome clinics to evaluate and potentially treat those individuals at highest risk of developing psychosis. Of note, these original clinics relied solely on interviews performed by clinicians rather than self-report surveys as the basis of diagnosis. In 1996, an Australian group led by Dr. Patrick McGorry established the first set of clinical criteria that were scientifically proven to help predict future psychosis. These criteria were used to establish a structured interview guide for clinicians to make such an early diagnosis. (In fact, Dr. McGorry and colleagues just published a new book that was covered in this blog a few days ago entitled, “Treating Schizophrenia in the Prodromal Phase”.)
A group at Yale University led by Dr. Tandy Miller and colleagues modified these criteria slightly to produce their own version of a prodromal structured clinical interview, known as the Structured Interview for Prodromal Syndromes (SIPS) a version of which (called the PRIME screening test) is now available for personal use on this web site. The Yale group validated their interview by demonstrating that 54% of diagnosed prodromal patients transitioned to full psychosis with a year. (Although at first glance, such a statistic may seem unimpressive, remember that on average only 1% of the overall population develops schizophrenia in a lifetime, so being able to predict that about half of a given population will do so is a large improvement in diagnostic accuracy.)
While such a result is promising, Dr. Loewy and colleagues felt that administering a detailed structured interview as a screening test for individuals at risk for developing schizophrenia in the near future (within 1-2 years) is not ideal because it requires specific training and several hours of clinicians’ time and therefore it would be difficult to implement for a large target population. As a result, Dr. Loewy and colleagues decided to design a self-report survey that individuals at risk could fill out themselves, entitled the Prodromal Questionnaire (PQ). This questionnaire is 92 items long and takes approximately 20 minutes to complete. The study reviewed here was an attempt by Loewy and colleagues to estimate how well their Prodromal Questionnaire (PQ) matched the previously validated structured clinical interview (SIPS) developed by the Yale group in an at-risk population. In other words, they sought to show how well a self-report survey could match an observational clinical interview in coming up with the same diagnosis of a schizophrenia prodrome.
The 92 items on the PQ are answered with true/false responses and are divided into four major subscales:
1) milder forms of positive symptoms (termed “unusual thinking” and “perceptual abnormalities” rather than full blown hallucinations or delusions)
2) negative symptoms (including limited facial expressions of emotions)
3) disorganized symptoms (such as odd behavior which is difficult to understand)
4) general symptoms (including depression and ability to perform daily activities of living)
The study included 158 individuals (age 12-35) who were referred to the UCLA prodromal schizophrenia clinic because of suspected prodromal psychotic symptoms. The majority of referrals were made by outpatient mental health clinicians who had previously seen a presentation by the clinic’s staff describing the center. 45 subjects were unable to complete the study and/or excluded from further analysis for various reasons, leaving 113 individuals who completed the PQ themselves and then were seen by mental health specialists who conducted the structured clinical interview (SIPS). All UCLA staff evaluators had been previously trained on the SIPS by its developer, Dr. Miller of Yale.
Of the 113 subjects with complete data, 37 met criteria for a current psychotic syndrome as assessed by the SIPS, 39 met criteria for a psychotic prodrome, and 37 did not meet criteria for either a prodromal or psychotic syndrome. The sample was 65% male, but otherwise diverse ethnically and not different based on final diagnosis. (It is important to note that about one-third (37/113) of the patients referred to the clinic were found to be experiencing fully psychotic syndromes suggesting that the referring clinicians may have been unaware of the presence or severity of the psychotic symptoms in some patients they treated. Therefore, it stands to reason a screening tool may be useful in identifying people who may otherwise go undetected and correspondingly not treated for their psychotic illness.)
Results indicated that total score on the PQ (self-report) scale predicted SIPS diagnosis of prodromal or psychotic syndrome versus no diagnosis with statistical accuracy. (In other words, the PQ generally identified the same people as having a psychotic or prodromal diagnosis as did the SIPS.) The positive symptom subscale score on the PQ also significantly predicted SIPS diagnostic status. However, scores on the other PQ subscales (negative symptoms, disorganized symptoms, general symptoms) did not predict SIPS-based prodromal status. (Such a result may have been expected considering that these types of symptoms are usually assessed better by observation than by self-report.) The PQ was best at predicting those with a symptomatic diagnosis (whether in the prodrome range or the having complete psychosis) versus those without. However, the PQ was not as sensitive as the SIPS at distinguishing between prodromal and psychotic syndrome diagnoses and the authors concede that the PQ “would be less than adequate in practice” for this purpose.
In summary, the authors show that a self-report questionnaire given to individuals at high risk of developing psychosis* is statistically capable of distinguishing between people with prodromal or psychotic syndrome diagnoses versus those with no diagnosis as assessed by a structured clinical interview. In other words, this self-report measure could be used to help screen out those who are referred to a prodrome clinic and who are not overly symptomatic and thus save clinical time and resources by not needing to perform a full evaluation on these individuals. Essentially, the PQ is well-suited as a tool to pre-select patients for more intensive interviewing.
For those interested in the detailed statistics, the authors point out that their results indicate the PQ alone would correctly reject about 5 out of 10 non-prodromal/non-psychotic participants at the cost of excluding 1 of 10 actual prodromal/psychotic cases. (Note: No screening test is perfect—a threshold must always be determined ahead of time to maximize true positives—those with the disease who are picked up by the test, and minimize false negatives—those who have the disease, but are told by the test that they do not, as well as minimize false positives—those who do not have the disease, but are told by the test that they do.)
Since this is a preliminary study, the authors caution against generalizing these results to a larger target population. They propose that the PQ as it stands now be used only for screening a clinical high risk population at specific prodrome clinics. The sample tested in their study was loaded in the sense that it had a very high base rate of the target syndrome (schizophrenia prodrome). In a more broad population, the sensitivity (ability of the test to successfully make the correct diagnosis when it existed) would be necessarily weaker. As a result, more false positives and false negatives would likely result. Moreover, the authors note that the presence of unusual psychotic experiences is actually quite high even in an unselected general population sample (18% of adults report such an experience in their lifetime that was not characterized as distressing), so it is important to limit the use of this questionnaire to those who feel such experiences are distressing and thus they are seeking treatment for that purpose. In other words, it is important to distinguish between unusual experiences and true symptoms or disorder, which must be complemented by distress and/or an effect on functioning of daily life. The authors note that they are currently working on modifying the PQ to assess level of distress in order to investigate the possibility of wider screening in non-clinical settings, such as schools and general medical facilities.
Further studies will attempt to repeat these results as well as examine the predictive validity of the PQ—how many of those labeled as prodromal according to the PQ go on to develop schizophrenia—a figure which was measured at >50% according to the SIPS, as mentioned earlier. Regardless, the PQ as it currently stands shows promise as a cost-effective way to screen for prodromal and previously undiagnosed psychotic symptoms in clinic-referred populations.
*as determined by mental health professionals who thought them worthy of receiving a referral to the prodrome clinic
Posted by Brian J. Schulman at November 17, 2005 11:46 AM
More Information on Schizophrenia Diagnosis
I am interested in your research but please use easier English!
Please could you also send a summary of what you feel is a greater factor-Background, or Genes?
Posted by: Hasan Abdulla at November 19, 2005 04:33 AM
Hi Mr. Schulman,
I am wondering about the concept of the prodrome in schizophrenia and schizoaffective disorder. Would you happen to know if schizoaffective disorder, bipolar type as it is defined in the united states has a prodrome? I've never heard of a prodrome for bipolar disorder (even those with full blown psychosis.) Does the prodrome belong to psychosis itself, or is it part of the pure schizophrenic illness? I am just wondering because if the prodrome belongs to schizophrenia, then the existence of a prodrome before outright psychosis should then be an indicator that the illness is closer to schizophrenia, rather than bipolar, no?
Posted by: Lluvia Zuniga at November 19, 2005 05:02 PM
I came across your site and thought you would help in suggesting or guiding me.
I originate from India. My mother has got the bipolar disorder and she is being treated for the same since 1984. We have used various kinds of medicines, she is normal for some period and later changes and we need to revise the medicine again. She feels disturbed and thinks people are talking about her, she become aggressive and shouts on family members, sometimes she does not take any medicines as well. After using the medicines sometimes she is hyperactive and does all her work, talks to people, goes around, does shopping everything. Another phase is where she is completely disturbed, never speaks to anyone, sometimes becomes aggressive, stops eating food, thinks people are talking about her etc. We are currently using medication for her though
Now I have another brother who is 27 yrs old now and I feel he is getting into this mood which my mother is. My brother is currently looking for jobs but its hard to get breakthrough. He now feels people are some how getting to know about him and that is the reason he is not being offered any job, he sleeps less and watches tv, sometimes eats in midnight, sometimes he feels people are suspicious about him etc. I consulted doctor and he said this might be the early stages of Schizophrenia. I am not sure whether to use the medicine to him or suggest him for some counselling or meditation classes ? Will he be normal after getting a job ? These questions are disturbing me everytime.
My only worry is my brother also should not become victim again like my mother. IS this something to do with Genes ? My maternal side no one has never undergone any disorders, my father side, my fathers mother has some kind of depression. Is this the cause ?
Can you suggest anything or wayforward to it ?
my email id is firstname.lastname@example.org.
Your suggestion and guidance will help me.
Posted by: AMP at November 20, 2005 06:23 AM
Thank you for your question. The prodrome does in fact belong to psychosis, broadly defined, not specifically to schizophrenia. When I refer to psychosis, I mean the entire DSM-IV schizophrenic spectrum: schizophrenia, schizophreniform disorder, schizoaffective disorder, brief psychosis, delusional disorder, and psychotic disorder Not Otherwise Specified (NOS).
Research suggests that symptoms in the prodrome phase cannot be distinguished between that which will eventually develop into schizophrenia vs. that which eventually develops into schizoaffective disorder.
For more info, please check out this PubMed abstract at: http://tinyurl.com/9rhpn
For the article's full text, go to: http://tinyurl.com/7d9sc
(Further, it is important to keep in mind that schizoaffective disorder, bipolar subtype should be distinguished from traditional Bipolar Disorder, which may display psychotic features in the manic and/or depressive phases. In order to meet criteria for schizoaffective disorder, bipolar subtype, one must have continuous psychotic features that manifest even in the ABSENCE of mood symptoms.)
Thus, the existence of a prodrome does not seem to indicate that an individual will develop schizophrenia vs. schizoaffective disorder. However, I should also note that research on the psychotic/schizophrenia prodrome is an evolving field, so any evidence must be taken as preliminary at this point in time.
Posted by: Brian J. Schulman at November 21, 2005 05:18 PM
a question for szadmin... With regards to research of schizophrenia, sense of self and prodromal phase, does any of the scientists today investigate the link between dreams and schizophrenia. Many of the people who expirienced sz say that is was a dream-like expirience. Maybe some hormons, neurotransmitters etc. involved in sz can be found in brain when people sleep?
Posted by: Brankica at November 22, 2005 07:49 AM
I have shizoaffective disorder and I agree that the best treatment for this and other mental health disorders is prevention through early diagnosis and education before symptoms occur. In my experience, once my symptoms occured, which was a slow process,it was impossible to reason with me. I was angry at any insinuation that I had a flaw; and I completly broke contact with my family.
Since I am adopted and there was no history of mental illness in my adoptive family, they were completly taken by surprize.
In my opinion once the symptoms occur it takes a miracle to convince the patient that there is a problem. In my case the miracle was suicidal ideation which did not fit in with my elaborate delusional world.
This led into a period when my every thought became suspect. I would think a thought and then immediately question the validity of that thought. Unless you've experienced this, it is hard to understand how disturbing this is. It was only through voluntary hospitalization and a change in my antipsychotic medication and the addition of antidepressants that I finally began the journey of replacing my delusional thinking with a "normal" view of the world. After 4 years I am still learning how to avoid the urge to throw myself into activities (mania) and stay home when I feel the need to launch into unnecessary and impulsive behavior and when paranoia or hallucinations creep into my world.
The only way I could have avoided all the unpleasantness, including homelessness and becoming emaciated, is if someone could have explained this disease and convinced me to start on medication prior to my symptoms (probably in my late teens or early twenties.)
I have never experienced a dream-like state--everything that I thought was happening to me seemed unmercifully real. I did experience an odd thing when I first started on Seroquel; when I'd lie down to go to sleep I started dreaming before falling asleep--I'd see the visual part of dreaming, but I was still conscious.
I've written entirely too much, but I think it's therapeutic.
Posted by: Sarah Ream at December 31, 2005 10:11 AM
For a person living in SF with a diagnosed and untreated schizo-affective disorder, what would be the first step to getting help? I haven't been treated for my problem in over 7 years. I'm open to clinics and whatever else, but am low income. I am afraid that I cannot afford the medication or treatment. Please advise, my illness is really beginning to effect me in ways I never imagined. Help.
Posted by: Sleepless in San Francisco at January 7, 2006 09:18 AM
i dont believe in schitzophrenia . it may exist but not as much as im told. i dont think i am schitzophrenic. i have been told i could possibly have it or something similar. what is schitzophrenia? Think people are talking about you? who says they aren't? People are judgemental. They have no life of their own and feel lost if there's no-one to single-out. Paranoid about people? think they are suspicious of you? Most are. We are protective of what we have, everyone is a possible threat to what we own. FACT. These seem to me nothing more than extensions of animal behaviour which we humans are. If we weren't so image conscious, forever striving to disociate ourselves from animals & nature because we have some idea that we are somehow different from that maybe we could learn how to live in a more realistic and practical way. This is how an animal reacts in the war-ridden world. Fear, suspicion, anger, mental illness. we have put ourselves in this position due to the unpractical & unrealistic values we place on ourselves. i'd like to say more but im not well educated.
Posted by: martyn at January 31, 2006 06:11 PM
You should make use of your local university's psychology clinic. They usually provide free services to the public, and you can get expert advice on the matter.
Posted by: Cheyne Harris at February 4, 2006 11:31 AM
hi, I'm currently doing some research for my psychology school project. My topic was drug abuse, but somehow along the way i realized that a lot of us had a twisted perception of schizophrenics. After reading some stuff over the net, I feel that i want people in my school to know the truth, or some version of it, about this disorder/illness. (controversial i no). Any one willing to be a case study, please e mail me at the above address, your personal information like ur name etc it not required, just need to ask some question-kinda like an internet interview. Thanx a lot
Posted by: Gemma at February 21, 2006 03:55 AM
hello gemma my name is shelley if i can answer any questions and help you please ask.
Posted by: shelley at February 23, 2006 02:10 PM
do any other sf suffer extreme weight gain if so what meds and if no what meds please help thanks shelley UK
Posted by: shelley at February 23, 2006 02:24 PM
my daughters boyfriend has a lot of the syptoms discribed with this illness
he has bad dreams of killing or knifing my daughter insomnia quick temper punching doors ect headaches says it like having people in his head himself and someone bad cant cope with the children when there noisey and doesent want to live anymore he smoke marijuana and used to drink but has given that up he's a nice person when normal but has mood swings and she has to be carfull when he changes or he can go berserk he is being refured to a psyciatris but im convinced he has the disease
Posted by: janet at March 18, 2006 04:27 AM
I took this test for my 7 yr. old son. I am currently working on my degree in psychology, I have an extensive family history of these types of behaviors. They all are prevalent in the males of my family. As I look back that is why my brother always tried to kill me. My 7 yr. old got in a fight with the man and that is what he calls the voice. The voice told him he did not like what they told him in church.... he proceided to tell the voice to shut up, and that he did like what they said in church. Well later that night the man told him to blow us up mind you i have 3 other children, the voice told him to put a lighter on the open flame of my stove in which my son complied. This is not the first time he has had my son do something very dangerous, once he had my son convieced that he could jump off the dresser through the wall, mind you my son did not make it through the wall. Please please please if you are expieriencing any of these things get help, for yourself or your s/o ......YOUR LIFE MAY DEPEND ON IT!!!!!!!!!!
Posted by: Amber at April 13, 2006 10:09 AM
Identifying a prodrome as part of the development of specifically schizophrenia via suggestive questionnaires, is dangerous.
These experiences coul be due to many other variables. Often they could be evidence of the brain adapting to the very rapid changes inthe western world. Regardless of what may ensue in the future the best way to deal with such experiences in ANYONE, is to focus on Strengths. Everybody has strengths and the development of these at an early stage will allow the person to take more responsibility for ther own health care in the future, regardless of whatever ill health they have. The group of illness' collectively termed the schizophrenias is viewed by medicine as having the common symptom of Lack of Insight, and resulting inability to direct ones own life.
I eperienced schizophrenic symptoms. I experienced medication. I still do experience some problems, but I experience my own self direction too. I take some medication for various health problems on and off. It is not wise to take it for the rest of my life. I also make sure I get extra nutrients as I have observed others in the mental illness prison are drastically malnourished because the medications they are on cover up symptoms of other illness. I am a unversity student at 32 Because my supporters saw my strengths and broke down some walls. I can break down the rest.
Posted by: rebecca green at May 8, 2006 09:56 PM
I have been in Mental "counseling" pretty much all my life I have been told i have"bipolar disorder""mood disorderNOS" Manic depressive schizophrenic you name it ive been told it I currently have yet another appt>. with Psychologist the 19th i am very concerned as your pretest showed me positive
Posted by: Linda at July 10, 2006 08:34 PM
i suffer from schiz but i dont tell enyone. i go though stagrs of very highs or lows. most times i want to kill myself but i have a daughter to thinf about so instead i became self distructinive in hurting myself like cutting or cutting i go off my pills as i hate lining my life dependant on them
Posted by: debby at July 29, 2006 12:40 PM
hi. i have been suffering from schiz for about 6 years now. i am 16 and what i think does not help is doctors telling me they know how im feeling. how could they?? apart from that they are amazing help. i know im different and i accept that. i have mood swings and drift off into my owm world quite often. my advice to anyone who thinks they may suffer from schiz is to get help. dont suffer alone. i tried and it didnt help. ok. by.xx
Posted by: Georgie at August 1, 2006 02:49 PM
I'm a 19 y.o. guy and I think I have maybe schizophrenia or schizotypal disorder. I have thought things like.. I will destroy the world, I know the secrets of existence, eveyone's against me, people (near and far) are talking about me, people talk about me until I enter the room... I can never express my thoughts right. I have believed that there are people/forces inside me that I can interact with... I get angry and resentful easily... envious of people who seem to me to function effortlessly... I always hear music in my head, looping, changing, but I can't turn it off. I can't stand being alone, and I get reeally paranoid when I'm alone. I freak out when people leave me. I feel like life is a movie in which the characters should be self-sufficient but keep bothering me. I space out all the time, dissociate, and things feel painful but not very real. I feel like I'm being watched all the time. I feel like inanimate objects are watching and judging me. I smoke tobacco excessively and overload on caffeine every day to feel awake and "with it". I am only comfortable around people if I'm drunk.
What is wrong with me??
Posted by: Andy T at August 7, 2006 10:55 AM
Well the last comment I lost. I'm not good on the computer at all. I took your test and it said positive. I've already been diagnosed with depression but not schizophrenia probably spelled wrong. My mother was a schizophrenic so when I seen the physochyatrist many times I was worried about that. He said definately not. My brother has alot of signs of schizophrenia. I work for a local hospital. A phsychologist said a son would inherit that gene from the mom. He does alot of strange things. Making up stories following through with plans of action that his wife can't understand. We've tried explaining this illness to her she won't believe any things wrong. He's saying he has iligitimate kids from a old girl friend from england that he met when he was in the service. He says she lives here now and she don't but he believes these things are all real.I don't feel the results of my test were positive at all. I work in a Hospice center. And trust when I write this. You see lots of strange things that go on there. And it's not just me that see these things it's everyone that works there. So we must all be schizophrenic. Thanks for your time and any comments you might have. Kim Stanley email@example.com
Posted by: Kimberly Stanley at August 7, 2006 04:35 PM
well...i have experiences of having very vivid hallucinations. periods of my life i get caught up in fixing the worlds problems, or alien conspiracies. i used to keep journals and read them later. and then burn them...or dumpster them. but i have never been treated for schizophrenia nor diagnosed as such. does it come and go? im always weird. isolated, a loner. and i think very different from most. and i hear voices music and see ghosts and such things. does it come and go?
Posted by: sandy at August 12, 2006 01:34 AM
im very interested bout the research seemingly it is still vauge for me to ponder lots of things bout SCHIZ, im a nursing student from the phillipines i got just finish in my psychiatris exposure and its fun yet i need lots of info why lots sufferfrom SCHIZ, hey break aleggg
Posted by: jerome salubre at October 9, 2006 07:18 PM
I've been diagnosed of having Shizo-affective Disorder since I was 16 years old and now I'm 27 and I'm still struggling with every second of my life because phsycosis is not a funny thing at all. Is it true that is incurable but it can be controlled by taking medicine? Thank you and I finally I would like to say to other sufferers all round the world that they should never give up.
Posted by: Maria Sapiano at October 26, 2006 12:37 PM
Okay, so I have been diagnosed with depression for quite some time and have always wondered if I wouldn't some day "go crazy" which later got translated into "have a psychotic break" or "become schizophrenic" when I found out the words. I'm a psychology major in my senior year who plans to pursue graduate study. At this point, I have managed to function in society relatively well... although almost everyone who knows me considers me to be significantly different from "normal." This has been increasing, especially in the last year or so, as have my strange thoughts and behaviors. Now, I know that everyone is going to say that of course I believe in my own delusions, but the thing is that all of my "strange thoughts" can be backed up by major philosophic, scientific or religious ideas. The "normal" view of the world has no grounds in science or even common sense. Our values make no sense to anyone who looks at them objectively (from another culture or even within our culture objectively ie. a trained sociologist). I have strange perceptions as well, but most of these fit with my view of the world. They are strange for others but not for me. Why is it that the majority view is automatically assumed correct? And it is only the majority view in this country. If you compare the quotes from schizophrenics and enlightened individuals there are such similarities that people are unable to tell the difference. I am not saying that all people diagnosed as schizophrenic fit this. I know that there are people who suffer and want help and want a relief from their suffering. I don't. But I live with a constant fear that I will make a mistake and act in the wrong way around the around individuals and find myself instituationalized. Please comment and let me know what you think.
Posted by: LovelyAnonymity at November 3, 2006 12:15 AM
Posted by: TARANDEEP at November 12, 2006 08:56 PM
this is very good artical.if u can please send me some questionnaire about tv advertisement effect on children
Posted by: udaya at December 27, 2006 12:30 AM
my dad comes home looking all dirty and unkept, i'm being abused and neglected. there's no income coming in, and i'm being told that i'm crazy. i hate my dad and i want to stay as far away from him as possible. it is so abhorrent, i hate men.
i want to get the hell out of this godforsaken house, and live somewhere cleaner and more pleasant, where people actually care about the other person. why do we have to choose between heaven and hell? i'm tired of fighting spiritual warfare inside my head, because reality isn't so pleasant. i need friends too.
i'm going to run away to my dad (jesse's) house. i know i'll be happy there.
Posted by: Jesse at January 26, 2007 07:40 AM
I would like to know if any of you that have left comments here (esp. those with any "disorders of consciousness"), have ever seen any of the following movies; "What the Bleep Do We Know?", "What the Bleep; Down the Rabbit Hole Quantum Edition", and "The Secret"(the non-fictional movie; not the "Hollywood" movie with the same name)? Please email me if you have firstname.lastname@example.org . If you haven't, I would suggest doing so. I believe these documentary-teachings to be the sign of a coming shift in awareness on the entire planet; and I believe that a lot of people with these so called "mental disorders" (esp. schizophrenic), may be receiving a sort of foresight into the coming paradigm shift. This is especially like in the case of someone such as "LovelyAnonimity", whose Nov. 3 post on here is what really prompted me to write this. Please, let's get it right humanity; our time may be running out, and we need a proper view of the world that we may be transformed from these confused little animals, into great beings of high intellect and wisdom.
Posted by: sasha at February 9, 2007 09:57 PM
It took years for the system to recognise my family member's psychosis and schizophrenia. I tried to get help but was powerless in every way and may have hindered instead of helped I don't know. Now there is a diagnosis and my family member is part of the mental health moulding process. Because it took so long for them to react my family member is considered a 'poor prognosis' therefore is tracked to lower levels of service. Now the team has convinced my family member that I am a major part of the problem. I think it is because I have been trying to get service. Now there is so much paranoia that I'm not allowed to see the granchildren. All I know is that I am waiting for something right to happen.
Posted by: toni at April 4, 2007 06:56 AM
i'm a research scholar need your guidance n help in making my research mphil synopsis if u can please reply me on my given email id.
good article from u learned a lot
waiting for positive reply
Posted by: muneeza at March 9, 2008 05:37 AM
i hate myself and make other misrable because of it, i wish i could loose weight, maybe people would like me?
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I think that this is a really neat place even though I am trying to find some pages for my reasearch paper for art.
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