title: Recruitment and treatment practices for help-seeking "prodromal" patients.
abstract: The prodrome of psychosis has become a target for early identification and for treatments that address both symptoms and risk for future psychosis. Interest and activity in this realm is now worldwide. Clinical trials with rigorous methodology have only just begun, making treatment guidelines premature. Despite the sparse evidence base, treatments are currently applied to patients in the new prodromal clinics, usually treatments developed for established psychosis and modified for the prodromal phase. This communication will describe representative samplings of how treatment-seeking prodromal patients are currently recruited and treated in prodromal clinics worldwide. Recruitment includes how prodromal patients are sought, initially evaluated, apprised of their high-risk status, and informed of the risks and benefits of prodromal treatments and how their mental state is monitored over time. The treatment modalities offered (and described) include engagement, supportive therapy, case management, stress management, cognitive behavioral treatment, family-based treatment, antipsychotic pharmacotherapy, and non-antipsychotic pharmacotherapy. References for details are noted.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. thomas.mcglashan@yale.edu
authors.forename: Thomas H
authors.initials: TH
authors.lastname: McGlashan
authors.forename: Jean
authors.initials: J
authors.lastname: Addington
authors.forename: Tyrone
authors.initials: T
authors.lastname: Cannon
authors.forename: Markus
authors.initials: M
authors.lastname: Heinimaa
authors.forename: Patrick
authors.initials: P
authors.lastname: McGorry
authors.forename: Mary
authors.initials: M
authors.lastname: O'Brien
authors.forename: David
authors.initials: D
authors.lastname: Penn
authors.forename: Diana
authors.initials: D
authors.lastname: Perkins
authors.forename: Raimo K R
authors.initials: RK
authors.lastname: Salokangas
authors.forename: Barbara
authors.initials: B
authors.lastname: Walsh
authors.forename: Scott W
authors.initials: SW
authors.lastname: Woods
authors.forename: Alison
authors.initials: A
authors.lastname: Yung
mesh_terms: D019090:Case Management; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003431:Cross-Cultural Comparison; D042241:Early Diagnosis; D006801:Humans; D007258:Informed Consent; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care; D018579:Patient Selection; D012308:Risk Management; D012559:Schizophrenia / Q000175:diagnosis / Q000517:prevention & control*; D012565:Schizophrenic Psychology; D012569:Schizotypal Personality Disorder / Q000175:diagnosis / Q000628:therapy*