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Advances in Psychiatric Treatment (2006) 12: 249-255
© 2006 The Royal College of Psychiatrists

Identification of young people at risk of psychosis

Sophie Parker and Shôn Lewis

Sophie Parker is a trainee clinical psychologist at the University of Manchester (Division of Clinical Psychology, University of Manchester, 2nd Floor Zochonis Building, Brunswick Street, Manchester M13 9LP, UK. Email: spophs{at}ntlworld.com). Her particular interests lie in detection and intervention for young people at risk of developing psychosis and links between trauma and psychosis. Shôn Lewis is Professor of Adult Psychiatry in the University of Manchester’s Education and Research Centre at the Wythenshawe Hospital Manchester. He has research interests in the causes and treatments of psychosis, especially early psychosis.

Operational criteria for detecting prodromal, or at-risk, mental states have been developed largely on the basis of individuals seeking help for attenuated or brief, self-limiting symptoms that do not meet threshold criteria for psychotic disorder. These individuals present largely to primary care and other non-specialist mental health settings. Follow-up studies have confirmed that 15–40% will make the transition to full psychosis within 12 months. Cognitive therapy alone or in combination with low-dose atypical antipsychotics has been shown to be efficacious in reducing or delaying the transition to psychosis, as well as in ameliorating the severity of non-psychotic symptoms and distress. Antipsychotic medication alone has not shown significant efficacy, but results are suggestive of some advantage from drug treatment. Further work is needed to clarify the relative merits of these interventions.




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