Early Intervention in Psychosis

Abstract

In the past 20 years, the evidence confirming the superiority of specialised early intervention services over generic care in managing the critical early phase of psychosis has grown steadily, and specialised early intervention services have been established in many parts of the developed world. The multidisciplinary, comprehensive and assertive approach of early intervention services was based on ground-breaking research showing the importance of minimising the duration of untreated psychosis, defining “at-risk” populations and optimising delivery of evidence-based treatment (psychotropic medication, other medication and non-pharmacological). Whilst studies have repeatedly shown positive short- and medium-term outcomes for early-intervention services, these appear to dissipate once care reverts to generic services. Early intervention in psychosis is now considered one of the most important mental health reforms since the era of deinstitutionalisation. Research efforts are now concentrating on understanding the pathophysiological processes that accompany the emergence and progression of psychosis, improving identification and treatment of at-risk mental states, developing focused early detection strategies and extending the early intervention paradigm to all youth mental health disorders.