Prediction and Early Detection of First-Episode Psychosis

Abstract

It has long been known that first episode psychosis is generally preceded by a prodromal phase that can even last up to decades. Different conceptualizations and models have been suggested during the last century. An early detection of first episode psychosis within this prodromal phase, however, was long thought to he impossible due to the assumed unspecific nature of complaints within the pre-psychotic period. This view has started to change during the last two decades. Since the late 1990s, increasing international research activities on an early detection have resulted in first promising findings. Within this new area of research, two main approaches can be identified, the German basic symptom concept, first introduced by Gerd Huber, and the Australo-American ultra-high risk concept, originally introduced by Patrick McGorry and Alison Yung. Another important step was the shift from a prodrome focussed to a risk focussed approach. Meanwhile, results from several studies indicate that both concepts have the ability to define samples with a considerably increased risk for developing a florid psychosis. The chapter will introduce the early and current concepts and review the evidence provided by the available studies.