Editors' Introduction: New Frontiers in Prodromal Research

Abstract

This special issue emerged indirectly from discussions that took place on a train ride from Bonn to Berlin after an international conference held in Germany in 2000. At that time, a handful of research programs had been started to investigate the period preceding the onset of full-blown psychosis in individuals displaying attenuated (i.e., subpsychotic intensity) positive symptoms. One of us (B.A.C.) was interested in starting a collaborative project with other prodromal researchers on that train. But after a lunch, a few beers, and a slight detour to look at castles, it became quite clear that many issues had to be resolved before an international, multisite collaboration on this topic would be feasible. For example, some consensus was needed on issues such as how to define risk, how to define the prodrome, and how to quantify prevention. Furthermore, because most prodromal projects were quite new, few had had time to publish their early findings, and communication among researchers about shared problems, experiences, and discoveries had been limited And so the idea of a small interactive working group to overcome some of these problems was born. The First Annual Workshop on the Schizophrenia Prodrome was held at the SoHo Grand Hotel in New York City from April 4 to 6, 2002. Made possible by an educational grant from Janssen Pharmaceutica Products, L.P., the workshop focused on methodological issues unique to the study of risk states. Initially, it was hoped that, if successful, the workshop might result in a short article that would announce the emergence of the prodromal research area and provide a rudimentary methodological framework for researchers seeking to establish new programs in this field. What emerged was three days of intense scientific discussion, a very definite spirit of collegiality, and enough new data and theory to justify an entire special issue. John Hsaio, the editor-in-chief of Schizophrenia Bulletin, recognized the potential contribution of such a volume, and Robert Heinssen, a major contributor to the workshop, agreed to serve along with Barbara Cornblatt as primary co-editors. Tyrone Cannon and Todd Lencz also agreed to join the editorial board of the special issue. It was apparent to all that the field of prodromal research was no longer in its infancy but was experiencing an exciting spurt of growth, with all of die accompanying growing pains. This special issue cannot solve all the problems that cropped up that day on the train, but we believe that it will provide a major push in the right direction. While most of the contributors to this issue participated in the 2002 workshop, there are also several invited articles and commentaries by researchers who were unable to attend. To maximize the potential impact of this issue on the field, the editors and authors agreed to an unusually stringent review process. Articles were sent to as many as four internationally recognized opinion leaders in the field of schizophrenia research, in addition to review by the editors themselves. Our thanks are extended not only to the authors, who returned very strong contributions with relatively short deadlines, but also to the reviewers, who provided extensive comments on even tighter deadlines. This meeting also led to the formation of the International Prodromal Research Network (TPRN), which is codirected by Barbara Comblatt and Tyrone Cannon. The goal of the network is to provide a forum for researchers to form collaborations and to pool resources and data in pursuing goals related to the prediction and prevention of schizophrenia and other forms of psychosis. IPRN activities are expected to generate a set of common assessment instruments and to pave the way for the multisite trials critical for amassing large samples, currently not available to any one site or study. The network will also coordinate future workshops and smaller working group meetings. The first of these was the Second Annual Workshop, held in Santa Monica, CA, from May 1 to 3, 2003, which was hosted by Tyrone Cannon and co-sponsored by Janssen Pharmaceutica Products, L.P., and by Garen and Shari Staglin. The Staglins have pledged ongoing support of the network through funds raised at the Music Festival for Mental Health, held annually at the Staglin Family Vineyard in Rutherford, CA. The sec-