The prodromal stage of psychotic illness: Observation, detection or intervention

The prodromal stage of psychotic illness: Observation, detection or intervention

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J Psychiatry Neurosci 2003;28(2):93-97

Jean Addington, PhD

Department of Psychiatry, University of Toronto, Toronto, Ont.

Abstract

Accurate identification of individuals in the earliest symptomatic stages of psychosis offers perhaps the best hope for more effective treatment strategies. Recently, research clinics have been set up to identify and possibly treat individuals who are seen as being at high risk of a psychotic disorder. However, there have been concerns about beginning treatment at this stage. We need to address these concerns so that individuals who are at risk of psychosis come to no harm, yet the development of potential interventions is not delayed. This article briefly reviews some of the newer developments and concerns in this area of psychosis research.

Résumé

L’identification exacte des personnes qui en sont aux premiers stades des symptômes de psychose offre peut-être le meilleur espoir d’élaborer des stratégies de traitement plus efficaces. On a créé récemment des cliniques de recherche pour repérer et, peut-être, traiter des personnes considérées comme à risque élevé de troubles psychotiques. Le début du traitement à ce stade soulève toutefois des préoccupations. Il faut y donner suite de telle façon que les personnes à risque de psychose ne subissent pas de préjudice, sans toutefois retarder la mise au point d’interventions possibles. Cet article passe brièvement en revue des préoccupations et des événements récents dans ce domaine de la recherche sur la psychose.


Medical subject headings: diagnosis; disease progression; patient care; psychiatric status rating scales; risk factors; schizophrenia and disorders with psychotic features; signs and symptoms; treatment outcome.

This paper was completed when Dr. Addington was an associate professor at the University of Calgary.

Submitted Apr. 30, 2002; Accepted July 24, 2002

Competing interests: None declared.

Correspondence to: Dr. Jean Addington, Centre for Addiction and Mental Health, 250 College St., Toronto ON M5S 2S1; fax 416 979-8501; jean_addington@camh.net