Schizophrenia Bulletin Advance Access originally published online on April 29, 2007
Schizophrenia Bulletin 2007 33(3):661-664; doi:10.1093/schbul/sbm031
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Editor's Introduction: The Empirical Status of the Ultra High-Risk (Prodromal) Research Paradigm
2 Departments of Psychology, Psychiatry, and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
3 Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, NY
4 Orygen Research Center and Department of Psychiatry, University of Melbourne, Melbourne, Australia
1 To whom correspondence should be addressed; tel.: 310-206-8765, fax: 310-794-9740, e-mail: cannon{at}psych.ucla.edu.
Given the growth of prodromal research in the past 15 years, the time seems right for assessing whether the ultra high-risk (UHR) research paradigm has delivered on its promise as an approach to identification of individuals at risk for imminent onset of psychosis and as a platform for studies assessing protective benefits of early interventions and for elucidating predictive markers. As demonstrated by the 8 articles on this theme in the present issue, the empirical basis of the prodromal research area has advanced significantly. While there is a lower risk for transition to psychosis in recent studies compared with initial studies, most recent studies still show a 30%–35% risk for psychosis within 1–2 years of follow-up, a rate that is substantially higher than the incidence rate of psychosis among transition age youth in the general population. Moreover, the means with which to improve this predictive equation is rapidly developing, enabled by the collaborative integration of data across multiple sites, the employment of multivariate risk algorithms, and a longitudinal perspective on symptoms, cognition, and functioning. All the initial intervention studies have produced encouraging findings, albeit with small sample sizes and relatively large attrition rates. Nevertheless, the findings in this issue, together with others like them appearing at an increasing rate in the world literature, indicate that the prodromal research area is increasing in maturity and sophistication, providing a useful heuristic for early detection and intervention in those at risk for psychosis.
Keywords: psychosis / prodrome / prevention
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