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Article: Intervention in individuals at ultra-high risk for psychosis: A review and future directions

TitleIntervention in individuals at ultra-high risk for psychosis: A review and future directions
Authors
Issue Date2009
PublisherPhysicians Postgraduate Press, Inc. The Journal's web site is located at http://www.psychiatrist.com
Citation
Journal Of Clinical Psychiatry, 2009, v. 70 n. 9, p. 1206-1212 How to Cite?
AbstractObjective: Over the last 15 years, a focus on early intervention in psychotic disorders has emerged. Initially, the early psychosis movement focused on timely recognition and phase-specific treatment of first-episode psychosis. However, early psychosis researchers suspected that pushing the point of intervention even further back to the prodromal phase of psychotic disorders may result in even better outcomes. This article reviews intervention research in the ultra-high-risk phase of psychotic disorders. Data sources: A literature search of intervention trials with ultra-high-risk cohorts published after 1980 was conducted on PubMed with the search terms prodrome and intervention. Study selection: All published intervention trials with ultra-high-risk cohorts. Data synthesis: The first generation of intervention trials indicated that both pharmacologic and psychological intervention strategies may be of value in terms of symptom reduction and delay or prevention of onset of threshold psychotic disorder. Conclusions: Further controlled intervention trials with larger sample sizes are required in order to confirm and extend these findings. We argue that the clinical staging model provides a framework for the rationale and design of such studies, with simpler, safer, and more benign interventions being better candidates for first-line treatment, while more complex and potentially harmful treatments should be reserved for those cases in which response has failed to occur. Recent evidence indicates that neuroprotective agents, such as essential fatty acids, may be a suitable form of intervention for the ultra-high-risk phase of psychotic disorders, with a positive risk-benefit balance. Ethical aspects have become more salient given the recently observed declining transition rate in ultra-highrisk samples. We outline the key questions for the next generation of ultra-high-risk intervention trials. © Copyright 2009 Physicians Postgraduate Press, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/171956
ISSN
2015 Impact Factor: 5.408
2015 SCImago Journal Rankings: 2.042
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMcgorry, PDen_US
dc.contributor.authorNelson, Ben_US
dc.contributor.authorAmminger, GPen_US
dc.contributor.authorBechdolf, Aen_US
dc.contributor.authorFrancey, SMen_US
dc.contributor.authorBerger, Gen_US
dc.contributor.authorRiecherRössler, Aen_US
dc.contributor.authorKlosterkötter, Jen_US
dc.contributor.authorRuhrmann, Sen_US
dc.contributor.authorSchultzeLutter, Fen_US
dc.contributor.authorNordentoft, Men_US
dc.contributor.authorHickie, Ien_US
dc.contributor.authorMcguire, Pen_US
dc.contributor.authorBerk, Men_US
dc.contributor.authorChen, EYHen_US
dc.contributor.authorKeshavan, MSen_US
dc.contributor.authorYung, ARen_US
dc.date.accessioned2012-10-30T06:18:48Z-
dc.date.available2012-10-30T06:18:48Z-
dc.date.issued2009en_US
dc.identifier.citationJournal Of Clinical Psychiatry, 2009, v. 70 n. 9, p. 1206-1212en_US
dc.identifier.issn0160-6689en_US
dc.identifier.urihttp://hdl.handle.net/10722/171956-
dc.description.abstractObjective: Over the last 15 years, a focus on early intervention in psychotic disorders has emerged. Initially, the early psychosis movement focused on timely recognition and phase-specific treatment of first-episode psychosis. However, early psychosis researchers suspected that pushing the point of intervention even further back to the prodromal phase of psychotic disorders may result in even better outcomes. This article reviews intervention research in the ultra-high-risk phase of psychotic disorders. Data sources: A literature search of intervention trials with ultra-high-risk cohorts published after 1980 was conducted on PubMed with the search terms prodrome and intervention. Study selection: All published intervention trials with ultra-high-risk cohorts. Data synthesis: The first generation of intervention trials indicated that both pharmacologic and psychological intervention strategies may be of value in terms of symptom reduction and delay or prevention of onset of threshold psychotic disorder. Conclusions: Further controlled intervention trials with larger sample sizes are required in order to confirm and extend these findings. We argue that the clinical staging model provides a framework for the rationale and design of such studies, with simpler, safer, and more benign interventions being better candidates for first-line treatment, while more complex and potentially harmful treatments should be reserved for those cases in which response has failed to occur. Recent evidence indicates that neuroprotective agents, such as essential fatty acids, may be a suitable form of intervention for the ultra-high-risk phase of psychotic disorders, with a positive risk-benefit balance. Ethical aspects have become more salient given the recently observed declining transition rate in ultra-highrisk samples. We outline the key questions for the next generation of ultra-high-risk intervention trials. © Copyright 2009 Physicians Postgraduate Press, Inc.en_US
dc.languageengen_US
dc.publisherPhysicians Postgraduate Press, Inc. The Journal's web site is located at http://www.psychiatrist.comen_US
dc.relation.ispartofJournal of Clinical Psychiatryen_US
dc.titleIntervention in individuals at ultra-high risk for psychosis: A review and future directionsen_US
dc.typeArticleen_US
dc.identifier.emailChen, EYH:eyhchen@hku.hken_US
dc.identifier.authorityChen, EYH=rp00392en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.4088/JCP.08r04472en_US
dc.identifier.pmid19573499-
dc.identifier.scopuseid_2-s2.0-70350441313en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-70350441313&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume70en_US
dc.identifier.issue9en_US
dc.identifier.spage1206en_US
dc.identifier.epage1212en_US
dc.identifier.isiWOS:000270246700002-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridMcGorry, PD=35426378300en_US
dc.identifier.scopusauthoridNelson, B=14071680700en_US
dc.identifier.scopusauthoridAmminger, GP=6602664420en_US
dc.identifier.scopusauthoridBechdolf, A=6601968099en_US
dc.identifier.scopusauthoridFrancey, SM=6603656802en_US
dc.identifier.scopusauthoridBerger, G=7202349101en_US
dc.identifier.scopusauthoridRiecherRössler, A=35451917300en_US
dc.identifier.scopusauthoridKlosterkötter, J=7005883787en_US
dc.identifier.scopusauthoridRuhrmann, S=6701546897en_US
dc.identifier.scopusauthoridSchultzeLutter, F=6602139887en_US
dc.identifier.scopusauthoridNordentoft, M=7006191523en_US
dc.identifier.scopusauthoridHickie, I=17734678500en_US
dc.identifier.scopusauthoridMcGuire, P=7101880438en_US
dc.identifier.scopusauthoridBerk, M=7102183860en_US
dc.identifier.scopusauthoridChen, EYH=7402315729en_US
dc.identifier.scopusauthoridKeshavan, MS=35147931300en_US
dc.identifier.scopusauthoridYung, AR=7006387307en_US
dc.identifier.citeulike10291755-

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