Early Detection of Psychosis: Challenges and Opportunities

Abstract

Early identification of individuals at clinical risk for psychotic illness is critical for early intervention. Current studies apply special assessment measures combined with neurocognitive, neuroimaging, and electrophysiology methodologies that have been discovered largely in schizophrenia research. While still limited in sample size, harmonized measures, and longitudinal data, these studies indicate the presence of abnormalities in the clinical-risk state. Such findings suggest that the onset of the psychotic process precedes late adolescence and clinical detection. Efforts at early identification, therefore, could benefit from large-scale studies. Computerized clinical assessment and neurocognitive testing are available and can move from academic sites to the community. Neuroimaging methods are increasingly available and can add to the prediction of transition. As a field, we need to move vigorously and responsibly toward early interventions that may prevent and ameliorate the developmental trajectory that leads to the emergence of a full psychotic disorder with devastating impact on individuals, families and communities.