Jury Out on Early Intervention for Psychosis

There is “emerging, but as yet inconclusive” evidence that individuals in the prodromal phase of psychosis can benefit from early intervention, although whether this will prevent progression to full-blown schizophrenia remains to be seen, conclude the authors of a new Cochrane review.

There is also “some support for phase-specific treatment focused on employment and family therapy, but again, this needs replicating with larger and longer trials,” authors Max Marshall, MD, University of Manchester, and John Rathbone, MD, University of Sheffield, United Kingdom, write.

The review appears in the latest issue of the Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.

Proponents of early intervention argue that schizophrenia outcomes may be improved if more efforts were focused on the early phase of psychosis. It’s estimated that about 10% to 20% of these individuals go on to develop full-blown schizophrenia. The aim of early intervention is to prevent this.

“The arguments in favor of early intervention have been so persuasive that early intervention teams are well-established in America, Europe and Australasia,” the authors note.

Early intervention in schizophrenia has 2 distinct goals. The first is the early identification of those likely to develop psychosis. These individuals display nonpsychotic prodromal symptoms but have never had a psychotic episode.

The second is phase-specific treatment that may include psychological, social, or physical treatment designed specifically for patients with early-stage illness. Early detection and phase-specific treatment may supplement standard care or may be provided through a specialized early intervention team.

However, clear-cut evidence of effectiveness of early intervention remains unclear, the authors note…….

By Megan Brooks
Medscape Medical News

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