Treatment of Adolescents and Young Adults Experiencing Attenuated Psychotic Symptoms

Abstract

Individuals, prior to the first psychotic episode, are symptomatic. Psychotic disorders in many cases develop gradually with a prolonged period of attenuated psychotic symptoms during which conventional criteria of DSM–IV disorders are not met. Young people are often not coping well with their symptom load. Because most of the disability which occurs in psychotic illness is entrenched during this phase, it is vital to explore the need of intervention prior to a first episode of psychosis. This article describes the development of the Personal Assessment and Crisis Evaluation (PACE) clinic in Melbourne, Australia. PACE is in unique service devoted to the systematic treatment and research of adolescents and young adults at high risk of psychosis who suffer perceptual distortions, unusual thoughts, or disorganized speech. The article reviews studies on treatment interventions in the prepsychotic phase and provides principles for the clinical management of young people considered at high risk for psychotic disorders.