The British Journal of Psychiatry (2007) 191: s1-s8. doi: 10.1192/bjp.191.51.s1
© 2007 The Royal College of Psychiatrists
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EDITORIALS

Prediction of psychosis: setting the stage

ALISON R. YUNG, MD, MPM, FRANZCP and PATRICK D. McGORRY, MD, PhD, FRANZCP

ORYGEN Research Centre and the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia

Correspondence: Alison Yung, ORYGEN Research Centre, Locked Bag 10, Parkville, Victoria, Australia. Tel: +61 3 9342 2000; fax +61 3 9342 2948; email: aryung{at}unimelb.edu.au

Declaration of interest None.

Treating psychotic disorders in their earliest stages has become a key focus for research and clinical care. This paper reviews evidence of the capacity to identify those at increased risk for psychotic disorder and to intervene in the identified, high-risk individuals to ameliorate the course of disorder. Issues involved in preventive oriented clinical care are addressed, such as risk/benefit considerations, ethical and safety issues and the value of stage-specific interventions. Clinical predictors identified in recent research, promising intervention trials and proposed clinical practice guidelines are described. An approach based on active engagement, support and monitoring, yet with a conservative approach to medication use is advocated at present. Potential neurobiological processes have been studied and reinforce the sense that this is a critical phase for active treatment, and may prove helpful in understanding the process of transition across stages of illness. More research is required in prediction, neurobiology and treatment.