The concept of population prevention: application to schizophrenia.
There is currently a debate about the appropriate approach to prevention of schizophrenia. While many argue that prevention efforts should focus on individuals at high risk of developing the illness, others argue for interventions that would reduce the risk in the whole population. This article situates the debate in a historical context. We find its antecedents in a classic 1940s and 1950s debate between British physicians George Pickering and Robert Platt on hypertension and trace a line from Pickering to the influential concept of population prevention formulated by his student Geoffrey Rose. We then discuss the potential application of population prevention to schizophrenia. The article concludes that population and high-risk prevention strategies can be complementary and that it may be feasible and appropriate to use them in combination.
Department of Psychiatry, Columbia University, USA. rm322@columbia.edu
Ramin
R
Mojtabai
Dolores
D
Malaspina
Ezra
E
Susser
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D018479:Early Intervention, Educational; D005260:Female; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011159:Population Surveillance; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012569:Schizotypal Personality Disorder / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*