Schizophrenia Bulletin Advance Access originally published online on May 4, 2007
Schizophrenia Bulletin 2007 33(3):715-726; doi:10.1093/schbul/sbm025
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Recruitment and Treatment Practices for Help-Seeking "Prodromal" Patients
2 Department of Psychiatry, Yale University School of Medicine, New Haven, CT
3 Department of Psychiatry, University of Toronto, Ontario, Canada
4 Department of Psychiatry, University of California Los Angeles, Los Angeles, CA
5 Department of Psychiatry, University of Turku, Turku, Finland
6 ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
7 Department of Psychiatry, University of North Carolina, Chapel Hill, NC
1 To whom correspondence should be addressed; 301, Cedar Street, New Haven, CT 06519; tel.: 203 737 2077, fax: 203 785 7855, e-mail: thomas.mcglashan{at}yale.edu.
The prodrome of psychosis has become a target for early identification and for treatments that address both symptoms and risk for future psychosis. Interest and activity in this realm is now worldwide. Clinical trials with rigorous methodology have only just begun, making treatment guidelines premature. Despite the sparse evidence base, treatments are currently applied to patients in the new prodromal clinics, usually treatments developed for established psychosis and modified for the prodromal phase. This communication will describe representative samplings of how treatment-seeking prodromal patients are currently recruited and treated in prodromal clinics worldwide. Recruitment includes how prodromal patients are sought, initially evaluated, apprised of their high-risk status, and informed of the risks and benefits of prodromal treatments and how their mental state is monitored over time. The treatment modalities offered (and described) include engagement, supportive therapy, case management, stress management, cognitive behavioral treatment, family-based treatment, antipsychotic pharmacotherapy, and non-antipsychotic pharmacotherapy. References for details are noted.
Keywords: schizophrenia / at-risk / managing
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