Early intervention in psychosis

IS PREVENTION OF SCHIZOPHRENIA POSSIBLE?

Groups that might be tested for susceptibility to psychosis are those young people with schizophrenia in the family, those who have experienced traumatic abuse or forms of addiction, those who are members of minority groups, or who are school drop-outs.

Another approach would be a social marketing campaign to offer treatment to young people who themselves apply for it.

There is some evidence that preventive intervention is effective. Early detection and intervention in psychosis is in the incubation phase, and there are dangers. Children may be brought into the psychiatric mill whilst not belonging there: in other words, they would not have developed a disorder anyway. Furthermore, children may be subjected to the negative effects of medication unnecessarily.

There is somewhat less risk with social intervention: psycho-education, family therapy, courses in budgeting etc. Will there be sufficient trainers to give the courses in view of the current economic climate? Interventions such as these may be expected to reduce later hospital admissions and thus might be cost-effective.

Part of the susceptibility to psychosis is inherited and part environmental. If the biological, genetic element can be separated out, then biological, medicinal treatments may be worth considering. If there are clear signs of social problems, then social interventions will be justified. A hazard is, however, that the biological and the environmental factors are interrelated.

We may conclude that only individuals who are at high risk of developing a psychosis should be checked out and offered treatment. There is no call for screening young people in general.

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