Early intervention in patients at ultra high risk of psychosis: benefits and risks
Article first published online: 10 MAR 2009
© 2009 John Wiley & Sons A/S
Acta Psychiatrica Scandinavica
Volume 119, Issue 6, pages 426–442, June 2009
How to Cite
De Koning, M. B., Bloemen, O. J. N., Van Amelsvoort, T. A. M. J., Becker, H. E., Nieman, D. H., Van Der Gaag, M. and Linszen, D. H. (2009), Early intervention in patients at ultra high risk of psychosis: benefits and risks. Acta Psychiatrica Scandinavica, 119: 426–442. doi: 10.1111/j.1600-0447.2009.01372.x
- Issue published online: 18 MAY 2009
- Article first published online: 10 MAR 2009
- Accepted for publication February 11, 2009
- psychotic disorder;
Objective: Prediction of transition to psychosis in the prodromal phase of schizophrenia has raised interest in intervention prior to the onset of frank psychosis. The aim of this review was to examine whether interventions in the prodromal phase have a favourable benefit/risk ratio.
Method: A literature search in PubMed, EMBASE and PsycINFO was performed.
Results: Three randomized clinical trials with antipsychotic medication and/or cognitive behavioural therapy as clinical intervention suggested a positive effect at the end of treatment, but no significant differences were found at the end of follow-up periods from 1 to 4 years. Naturalistic studies present a hypothesis about a possible preventive effect of antidepressive medication. The results of eight other studies are more difficult to interpret. Side-effects of antipsychotic medication and non-adherence with medication are essential problems.
Conclusion: At the present time, the data concerning the benefits and risks do not justify prodromal intervention as standard clinical practice.