Aims/Background

Social rituals are expected activities that are part of everyday life in all communities. In normal circumstances, these behaviours are conducted in a culturally recognised manner. Accordingly, culturally inappropriate performance of them is usually noticed by social others. This project examined whether such behavioural irregularities can be regarded as prodromal psychiatric symptoms, early recognition of which is imperative to the early diagnosis and effective treatment of mental disorders.

Phase I entailed the development of the Social Rituals Schedule (SRS). It is a semi-structured interview that rates the degree of changes observed across several domains determined as universal social rituals via extensive analysis of socio-anthropological studies and literature (e.g. personal appearance, sleeping habits, greeting rituals). During Phase II, the psychometric properties of the SRS were then evaluated and the instrument proved to have good inter-rater reliability and to be sensitive to changes characteristic of prodromal symptoms. In Phase III, the SRS was administered on 30 early episode psychosis patients and their carers and the results were comparatively analysed to determine the agreement between patient-carer observations of behavioural changes.

The hypothesised interconnectedness of altered performance of social rituals and impaired mental functioning was demonstrated. The SRS was established as a sensitive, feasible and reliable tool for measuring changes characteristic of prodromal symptoms. The project illustrated the clinical usefulness of the social rituals concept and its accompanying instrument in facilitating the early detection of mental disorders.