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Young people at ultra high risk for psychosis: a research update


  • Declaration of conflict of interest: The authors have no conflicts of interest.

Professor Alison R. Yung, Orygen Youth Health Research Centre, The University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Vic. 3052, Australia. Email:


Aim: Over the last fifteen years attempts have been made to prospectively identify individuals in the prodromal phase of schizophrenia and other psychotic disorders. The ‘ultra high risk’ approach, based on a combination of known trait and state risk factors, has been the main strategy used. The validation of the ultra high risk criteria led to a series of intervention studies in this population. The aim of this paper is to provide an overview of ultra high risk research.

Method: We review studies in this area, focusing on intervention research. Intervention studies have included the use of low dose antipsychotic medication, cognitive therapy, and omega-3 fatty acids.

Results: The evidence for specific intervention strategies for this population is moderate and requires replication with larger samples.

Conclusion: Recently, it has been proposed to include an adaption of the ultra high risk criteria in the next version of the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). This has raised some controversy in the field. The authors conclude that it would be premature to include the Risk Syndrome in the Diagnostic and Statistical Manual of Mental Disorders at this stage.