Prediction of Psychosis in Youth at High Clinical Risk

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Abstract
Can prevention models now common to medicine be applied to psychotic disorders? Advances in early detection and intervention in cardiovascular disease,1 diabetes mellitus,2 and cancer3,4 have led to substantial reductions in morbidity and mortality and improved quality of life among individuals with these conditions. Efforts to extend such a prevention approach to schizophrenia have focused on developing and validating criteria for ascertaining individuals at risk for imminent onset of psychosis (ie, clinical high-risk or prodromal patients) and following them over time.5-7 The aims are to improve understanding of the mechanisms of disease onset and progression and to facilitate application of interventions before the illness takes hold, thereby reducing or preventing the devastating effects of schizophrenia. An advantage of this approach over high-risk methods based on a family history of schizophrenia is that assessments can be timed much more efficiently in relation to the onset of disorder.8