Treatment history in the psychosis prodrome: characteristics of the North American Prodrome Longitudinal Study Cohort.
OBJECTIVE
Early identification and better characterization of the prodromal phase of psychotic illness can lead to targeted treatment and, perhaps, prevention of many of the devastating effects of a first psychotic episode. The primary aim of this manuscript is to describe the treatment histories of a large cohort of individuals who entered into one of seven prodromal research programs in a North American Prodrome Longitudinal Study consortium.


METHODS
Treatment histories from 372 clinical high-risk subjects are described along with demographic, symptom, diagnostic and functional variables that may have contributed to treatment decisions for this group of individuals.


RESULTS
Of all subjects included, 82.1% had received psychosocial and/or pharmacologic treatment prior to entry. Psychosocial interventions were more common in the attenuated psychotic syndrome prodromal sample, especially those with more negative, disorganized or general symptoms and more impaired functioning. Psychotropic medication had been administered to individuals with a history of Axis I disorders.


CONCLUSIONS
Given the many potential clinical presentations, treatments and ethical issues connected with the psychosis-risk syndrome, it is not surprising that clinicians administered a broad range of interventions to study participants prior to their entry into the various research programs. Those individuals with milder and non-specific symptoms were more likely to have received psychosocial treatments, whereas those with more severe symptoms received pharmacologic intervention. Clinical treatment research is needed that addresses the complexities of these psychosis-risk states and helps to specify appropriate treatment at different stages of the psychosis prodrome.
Cadenhead
Kristin S
KS
Department of Psychiatry and Biobehavioral Sciences, UCSD, San Diego, California 92093-0810, USA. kcadenhead@ucsd.edu
Addington
Jean
J
Cannon
Tyrone
T
Cornblatt
Barbara
B
McGlashan
Thomas
T
Perkins
Diana
D
Seidman
Larry
L
Tsuang
Ming
M
Walker
Elaine
E
Woods
Scott
S
Heinssen
Robert
R
D000293:Adolescent; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009656:North America; D010818:Practice Patterns, Physicians' / Q000639:trends; D011613:Psychotherapy / Q000379:methods*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy*; D055815:Young Adult
D014150:Antipsychotic Agents