Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-10T07:38:49.040Z Has data issue: false hasContentIssue false
  • English
  • Français

Early detection and intervention of schizophrenia: rationale and research

Published online by Cambridge University Press:  06 August 2018

Thomas H. McGlashan
Thomas H. McGlashan*
Affiliation:
Yale Psychiatric Institute, Yale University, New Haven, Connecticut, CTO6520-8038, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Background The primary rationale for early detection and intervention in schizophrenia is the disorder's severity, chronicity and treatment resistance. This suggests that researchers pay closer attention to schizophrenia's premorbid and onset phases, when the vulnerability to psychosis becomes expressed and the neurobiological deficit processes driving symptom formation appear to be the most active.

Method We review the evidence that brain plasticity may be retained or reversed despite deficit processes.

Results The data are preliminary but suggestive enough to warrant further research.

Conclusions Overall, we need to focus on the early course of schizophrenia, detecting cases early at onset or in the prodrome, testing whether this enhances treatment response and prognosis, and predicting at-risk cases early in the prodromal phase. Designs to address these questions are presented, and relevant issues are discussed.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 172 , Issue S33: Verging on reality , June 1998 , pp. 3 - 6
Copyright
Copyright © 1998 Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beiser, M., Erickson, D., Fleming, J. A. E., et al (1993) Establishing the onset of psychotic illness. American Journal of Psychiatry, 150, 1349–1354.Google Scholar
Bilder, R. M., Lipschutz-Broch, I., Reiter, G., et al (1992) Intellectual deficits in first-episode schizophrenia: Evidence for progressive deterioration. Schizophrenia Bulletin, 18, 437–448.Google Scholar
Crow, T. J., MacMillan, J. F., Johnson, A. L., et al (1986) A randomised controlled trial of prophylactic neuroleptic treatment. British Journal of Psychiatry, 148, 120–127.Google Scholar
Falloon, I. R. H. (1992) Early intervention for first episodes of schizophrenia: A preliminary exploration. Psychiatry, 55, 4–15.CrossRefGoogle ScholarPubMed
Goldberg, T. E., Hyde, T. M., Kleinman, J. E., et al (1993) Course of schizophrenia: Neuropsychological evidence for a static encephalopathy. Schizophrenia Bulletin, 19, 797–804.Google Scholar
Helgason, L. (1990) Twenty years’ follow up of first psychiatric presentation for schizophrenia: What could have been prevented? Acta Psychiatrica Scandinavica, 81, 231–235.Google Scholar
Hoff, A. L., Riordan, H., O'Donnell, D.W., et al (1992) Neuropsychological functioning of first-episode schizophreniform patients. American Journal of Psychiatry, 149, 898–903.Google ScholarPubMed
Hoffman, R. E. & McGlashan, T. H. (1993) Parallel distributed processing and the emergence of schizophrenic symptoms. Schizophrenia Bulletin, 19, 119–140.Google Scholar
Johnstone, E. C., Crow, T. J., Johnson, A. L., et al (1986) The Northwick Park Study of first episode schizophrenia: I. Presentation of the illness and problems relating to admission. British Journal of Psychiatry, 148, 115–120.Google Scholar
Lehman, A. F., Carpenter, W.T., Goldman, H. H., et al (1995) Treatment outcomes in schizophrenia: Implications for practice, policy and research. Schizophrenia Bulletin, 21, 669–675.CrossRefGoogle ScholarPubMed
Lo, W. H. & Lo, T. (1977) A ten-year follow-up study of Chinese schizophrenics in Hong Kong. British Journal of Psychiatry, 131, 63–66.Google Scholar
Loebel, A. D., Lieberman, J. A., Alvir, J. M. J., et al (1992) Duration of psychosis and outcome in first episode schizophrenia. American Journal of Psychiatry, 149, 1183–1188.Google Scholar
McGlashan, T. H. (1996) Early detection and intervention in schizophrenia: Research. Schizophrenia Bulletin, 22, 327–345.Google Scholar
McGlashan, T. H. & Fenton, W. S. (1993) Subtype progression and pathophysiologic deterioration in early schizophrenia. Schizophrenia Bulletin, 19, 71–84.Google Scholar
McGorry, P. D., Edwards, J., Mihalopoulos, C., et al (1996) EPPIC: An evolving system of early detection and optimal management. Schizophrenia Bulletin, 22, 305–326.CrossRefGoogle ScholarPubMed
Moscarelli, M. (1994) Health and economic evaluation in schizophrenia: Implications for health policies. Acta Psychiatrica Scandinavica, 89 (suppl. 382), 84–88.Google Scholar
Opjordsmoen, S. (1991) Long-term clinical outcome of schizophrenia with special reference to gender differences. Acta Psychiatrica Scandinavica, 83, 307–313.Google Scholar
Rabiner, C. J., Wegner, J. T. & Kane, J. M. (1986) Outcome study of first episode psychosis: I. Relapse rates after 1 year. American Journal of Psychiatry, 143, 1155–1158.Google Scholar
Wyatt, R. J. (1991) Neuroleptics and the natural course of schizophrenia. Schizophrenia Bulletin, 17, 325–351.Google Scholar
Yung, A. R., McGorry, P. D., McFarlane, C. A., et al (1996) Monitoring and care of young people at incipient risk of psychosis. Schizophrenia Bulletin, 22, 283–303.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.