["Trema, apophany, apocalypse"--is Conrad's phase model empirically founded?]

Abstract

Among several phase models of beginning schizophrenia, the study by Conrad ("Die beginnende Schizophrenie. Versuch einer Gestaltanalyse des Wahns") was particularly impressive in German psychiatry. The ABC-Schizophrenia-study with its representative sample of 267 first-admissions and a careful retrospective assessment of emerging symptomatology made it possible to test the empirical basis of Conrad's model. In this operationalization "trema" was confirmed as the frequent first stage of the disease process, whereas Conrad's hypothesized order of the two following phrases (first "apophany", then "apocalypse") could not be validated. Therefore, Conrad's model cannot completely be generalized. Because the methods employed so far have some limitations, analyses of additional data (especially reports by significant others) may control and probably enhance the presented results.