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Pharmacological intervention in the initial prodromal phase of psychosis

Published online by Cambridge University Press:  16 April 2020

Stephan Ruhrmann*
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
Frauke Schultze-Lutter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
Wolfgang Maier
Affiliation:
Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
Joachim Klosterkötter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
*
*Corresponding author. E-mail address: stephan.ruhrmann@uni-koeln.de (S. Ruhrmann).
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Abstract

Early identification and treatment of schizophrenia may alleviate the symptoms, delay the onset and improve the outcome of psychosis. Thus, detection of individuals at risk during the prodromal phase is an important task. Universal approaches to screen the general population or healthy subjects at risk have not proven possible to-date. However, clinical criteria for detecting ultra-high risk individuals have been developed for specialized settings, with their implementation in interventional studies. This article examines the rationale for early detection and intervention of psychosis, along with a review of some of the current studies. These target prevention using psychological and/or pharmacological intervention strategies have demonstrated promising results in high risk individuals. The German Research Network on Schizophrenia (GRNS) is conducting two multicenter early intervention studies; one with early psychological intervention in subjects who manifest early prodromal symptoms; with the second trial applying clinical management and pharmacological early intervention in subjects experiencing late prodromal symptoms (high risk subjects). Despite the promising results, many of the current studies have small sample sizes with study durations of a short period. The full benefits of early detection and intervention should be revealed once larger and longer studies are conducted.

Type
Original article
Copyright
Copyright © Elsevier SAS 2005

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