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