Research Topic

Early Intervention in Psychotic Disorders

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Psychotic disorders such as schizophrenia are often chronic and disabling in a number of domains, including social and occupational functioning. They typically begin in adolescence or early adulthood, and major changes in the psychosocial functioning of patients with schizophrenia spectrum disorders are often ...

Psychotic disorders such as schizophrenia are often chronic and disabling in a number of domains, including social and occupational functioning. They typically begin in adolescence or early adulthood, and major changes in the psychosocial functioning of patients with schizophrenia spectrum disorders are often evident within the first 3 years after onset, although the decline in functioning tends to plateau thereafter. Intervention during the early stages of the disorder can reduce its ultimate severity. Therefore, the first 3 years of this disorder have been described as a critical period, during which the patient’s future disease course and prognosis are determined.

Recently, the retrospective focus on the prodrome has been replaced by a prospective one on ultra-high risk or clinical high risk, with the aim of effectively identifying people who may be at risk of developing a psychotic disorder and, perhaps, preventing its progression. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), includes attenuated psychosis syndrome (APS) as a new diagnosis in Section 3, the section devoted to conditions requiring further research. Early intervention in psychotic disorders generally has two objectives: to prevent the onset of schizophrenia in people with prodromal symptoms and to provide effective treatment to people in the early stages of schizophrenia, with the goal of reducing the severity of the illness.

Over the last three decades, numerous studies have investigated the early stages of psychotic disorders. These studies, focusing on patients with early psychosis, provide an opportunity to identify factors associated with prevention and treatment outcomes and offer results suggesting how early intervention in psychosis might be the best way to reduce the social and medical burden of schizophrenia. However, scientifically derived data addressing many domains of early intervention in psychotic disorders are needed. For example, further research should be conducted to identify markers for predicting psychotic conversion in patients with APS and candidates for antipsychotic discontinuation in patients with first-episode psychosis, to investigate the effectiveness of psychosocial intervention and early intervention services, and to understand the clinical course and pathogenesis of schizophrenia beginning at a very early stage of the illness.

This Research Topic will provide a forum for translational and clinical research conducted in the early stages of psychotic disorders, from the prodromal period before psychotic conversion to the critical period after the onset of psychosis. Contributions to this Research Topic can be either original research papers or review articles that provide a comprehensive overview of current literatures. Papers will address current biological, psychological, and social issues in this field. In addition, they will cover the pathogenesis and clinical course of psychoses and the outcomes and effectiveness of various treatments. Overall, articles addressing this topic will facilitate our understanding of early psychosis and contribute to the development of effective early intervention strategies.


Keywords: Schizophrenia, Psychosis, Ultra-high risk, Youth mental health, Prevention


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