title: Pharmacological prevention and treatment in clinical at-risk states for psychosis.
abstract: Over the last couple of decades, the treatment of psychoses has much advanced; yet, despite all progress, the individual and societal burden associated with psychosis and particularly schizophrenia has largely remained unchanged. Therefore, much hope is currently placed on indicated prevention as a mean to fight these burdens before they set in. Though the number of studies investigating pharmacological interventions is still limited, encouraging results have been reported from the pioneering trials, despite several methodological limitations. Furthermore, it has become clear that persons characterized by the at-risk criteria are already ill and do not only need preventive intervention, but also treatment. In consequence, outcome criteria have to be broadened to cover the current needs of the patients. As is indicated by a recent study successfully using Omega-3 fatty acids for both purposes, it may be promising to develop and investigate interventions especially for the at-risk state, independent of their effectiveness in manifest disease states. Treatment studies may become promoted by the proposed introduction of a new disorder category into DSM-V. Future prevention studies, however, need to solve the challenge of changing immediate transition rates, demanding for new risk enrichment strategies as a prerequisite for feasible trial designs.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Germany. stephan.ruhrmann@uk-koeln.de
authors.forename: Stephan
authors.initials: S
authors.lastname: Ruhrmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Klosterkötter
authors.forename: Mitja
authors.initials: M
authors.lastname: Bodatsch
authors.forename: Andreas
authors.initials: A
authors.lastname: Bechdolf
authors.forename: Benno Graf
authors.initials: BG
authors.lastname: Schimmelmann
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nikolaides
authors.forename: Desiree
authors.initials: D
authors.lastname: Hilboll
authors.forename: Frauke
authors.initials: F
authors.lastname: Schultze-Lutter
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D006801:Humans; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000517:prevention & control* / Q000523:psychology; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D015525:Fatty Acids, Omega-3