Early Intervention in Psychosis

Rationale, Results and Implications for Treatment of Adolescents at Risk

The authors use a review of theoretical, conceptual and empirical background for research on early identification, and intervention for improved outcomes in psychiatric disorders. to argue that existing evidence justifies early identification and prevention of psychosis as routine clinical practice.

Increased knowledge of the pathophysiology of psychotic disorders has led several groups to develop assessment and treatment interventions early in the first episode, or in the time between the onset of subtle and frank symptoms (the prodromal period).

Early treatment is increasingly seen as necessary for preventing the onset of psychosis, and is especially possible given the year-long or longer prodromal period. Eight trials of detection, intervention and prevention strategies from the UK, Australia, Scandinavia, Germany, Austria and North America all led to reductions in prodromal and psychotic symptoms as well as onset of frank psychosis. However, no single strategy has yet appeared to be superior.

Existing evidence suggests that clinicians working with adolescents should offer treatments and interventions as early as possible. The authors recommend that further research refine assessment methods for more predictive power, and adapt treatments to conditions present during the prodromal period. They also suggest that large-scale clinical trials and effectiveness studies would help achieve improved assessment accuracy and treatment efficacy.