Objective To identify the core constitutions and prodromal symptoms of relapse in schizophrenia patients using network analysis, and to analyze their relationships as well as gender differences.

Methods Schizophrenia patients hospitalized in the psychiatry department of Hunan Brain Hospital in Hunan Province between October 2022 and December 2023 were selected as survey participants. A general information questionnaire, a Traditional Chinese Medicine Constitution Scale, and a Schizophrenia Prodromal Symptoms of Relapse Scale were used for investigation. Network analysis was conducted using R language.

Results The core constitutions of schizophrenia patients were qi deficiency constitutionExpected Influence (EI)=1.08 and dampness-heat constitution (EI=1.00), and the core prodromal symptoms of relapse were depression/withdrawal (EI=0.84) and initial psychotic manifestations (EI=0.81). There were statistically significant differences in constitutions of traditional Chinese medicine and prodromal symptoms of relapse between patients of different genders (P < 0.05). Females mainly exhibited qi deficiency constitution (EI=1.20) with anxiety as the core prodromal symptom (EI=0.98), while males mainly exhibited yin deficiency constitution (EI=1.05) with depression/withdrawal as the core prodromal symptom (EI=1.00).

Conclusion Healthcare professionals can early identify core prodromal symptoms of relapse by core imbalanced constitutions of schizophrenia patients, and develop precise intervention strategies, thereby promoting changes in their network structure, preventing disease relapse, and improving patients' quality of life.