Recruitment and treatment practices for help-seeking "prodromal" patients.
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.
McGlashan
Thomas H
TH
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. thomas.mcglashan@yale.edu
Addington
Jean
J
Cannon
Tyrone
T
Heinimaa
Markus
M
McGorry
Patrick
P
O'Brien
Mary
M
Penn
David
D
Perkins
Diana
D
Salokangas
Raimo K R
RK
Walsh
Barbara
B
Woods
Scott W
SW
Yung
Alison
A
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*