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Treatment history in the psychosis prodrome: characteristics of the North American Prodrome Longitudinal Study Cohort


  • Financial Support: This work was supported by the National Institute of Mental Health R01 MH60720 and K24 MH76191 to KSC, U01 MH066134 to JA, R01 MH065079 to TDC, R01 MH061523 to BAC, K05MH01654 to THM, U01 MH066069 and P50 MH064065 to DOP, R01 MH065562 and P50 MH080272 to LJS, R21MH075027 to MTT, RO1MH062066 to EFW, U01 MH066160 to SWW, Donaghue Foundation to SWW and Eli Lilly & Co to THM, JA, and DOP.

Dr Kristin S. Cadenhead, Department of Psychiatry, 0810, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0810, USA. Email:


Aim: Early identification and better characterization of the prodromal phase of psychotic illness can lead to targeted treatment and, perhaps, prevention of many of the devastating effects of a first psychotic episode. The primary aim of this manuscript is to describe the treatment histories of a large cohort of individuals who entered into one of seven prodromal research programs in a North American Prodrome Longitudinal Study consortium.

Methods: Treatment histories from 372 clinical high-risk subjects are described along with demographic, symptom, diagnostic and functional variables that may have contributed to treatment decisions for this group of individuals.

Results: Of all subjects included, 82.1% had received psychosocial and/or pharmacologic treatment prior to entry. Psychosocial interventions were more common in the attenuated psychotic syndrome prodromal sample, especially those with more negative, disorganized or general symptoms and more impaired functioning. Psychotropic medication had been administered to individuals with a history of Axis I disorders.

Conclusions: Given the many potential clinical presentations, treatments and ethical issues connected with the psychosis-risk syndrome, it is not surprising that clinicians administered a broad range of interventions to study participants prior to their entry into the various research programs. Those individuals with milder and non-specific symptoms were more likely to have received psychosocial treatments, whereas those with more severe symptoms received pharmacologic intervention. Clinical treatment research is needed that addresses the complexities of these psychosis-risk states and helps to specify appropriate treatment at different stages of the psychosis prodrome.

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