Affiliation: Maine Medical Center Research Institute, Tufts University Medical School, 22 Bramhall Street, Portland, Maine 04012, USA.
This article reviews the theoretical, conceptual and empirical background for the current and growing research on early identification and early intervention to obtain improved outcomes in psychotic disorders. The goal is to prevent episodes of psychosis and the functional disability that accompanies them. Described are the studies linking duration of untreated psychosis and later outcomes, the precedents for psychosis, current methods for assessing the likelihood of onset, and the treatment trials conducted to date. We conclude that the evidence is increasing that justifies early identification and prevention being routine clinical practice. We also conclude that further research needs to refine assessment methods to achieve higher predictive power and that treatments need to be better adapted to the specific conditions usually present during the prodromal period. Finally, larger-scale clinical trials and effectiveness studies need to be carried out to achieve better assessment accuracy and treatment efficacy. Such studies are currently underway in North America and Europe, with results expected in 2012.