Abstract
SUMMARYEarly detection and specialised early intervention for people at high risk for psychotic disorders have received growing attention in the past few decades, with the aim of delaying or preventing the outbreak of explicit psychotic symptoms and improving functional outcomes. This article summarises criteria for a diagnosis of high psychosis risk, the implications for such a diagnosis and recommendations for treatment.LEARNING OBJECTIVESAfter reading this article you will be able to: •recognise signs and symptoms indicating increased psychosis risk•understand uses and limitations of screening for high psychosis risk, and interpretation of results•recognise evidence-based treatment options for patients at clinical high risk for psychosis.DECLARATION OF INTERESTC.A. has received non-financial support from Sunovion and Lundbeck in the past 36 months.
Highlights
Reality testing is intact, her experiences do cause some concern and have an impact on her sleep. Their frequency is sufficient for a diagnosis of attenuated psychotic symptoms, given that the symptoms have been present for less than a year
Specialised early intervention services have been shown to reduce the occurrence of psychotic transition in high-risk individuals; in patients with a first psychotic episode, they contribute to reduction of the duration of untreated psychosis (Oliver 2018) and reduce the need for in-patient treatment and compulsory admissions (Fusar-Poli 2016c)
Almost three decades have passed since the introduction of operationalised criteria for the identification of individuals at high risk for psychosis
Summary
Anna suffers from visual and auditory hallucinations. reality testing is intact, her experiences do cause some concern and have an impact on her sleep. Specialised early intervention services have been shown to reduce the occurrence of psychotic transition (van der Gaag 2013) in high-risk individuals; in patients with a first psychotic episode, they contribute to reduction of the duration of untreated psychosis (i.e. the time between onset of symptoms and the beginning of treatment) (Oliver 2018) and reduce the need for in-patient treatment and compulsory admissions (Fusar-Poli 2016c). These benefits have been acknowledged by several national and international guidelines, which consider assessment by a specialised early intervention service as an BOX 5 Case vignette: Mike – clinical course of BLIPS. Promising results that were initially obtained for omega-3 fatty acids (Amminger 2010, 2015) could not be replicated in a larger randomised controlled trial (McGorry 2017; Nelson 2018)
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