title: Primary prevention of psychosis through interventions in the symptomatic prodromal phase, a pragmatic Norwegian Ultra High Risk study.
abstract: BACKGROUND
  Evidence has been accumulating that it may be possible to achieve prevention in psychotic disorders. The aim of the Prevention Of Psychosis (POP) study is to reduce the annual incidence of psychotic disorders in a catchment area population through detection and intervention in the prodromal phase of disorder. Prodromal patients will be recruited through information campaigns modelled on the Scandinavian early Treatment and Intervention in Psychosis (TIPS) study and assessed by low-threshold detection teams.
  
  
  METHODS
  The study will use a parallel control design comparing the incidence of first episode psychotic disorders between two Norwegian catchment areas with prodromal detection and treatment (Stavanger and Fonna) with two catchment areas without a prodromal intervention program (Bergen and Østfold). The primary aim of the current study is to test the effect of a Prodromal Detection and Treatment program at the health care systems level. The study will investigate: 1) If the combination of information campaigns and detection teams modelled will help in identifying individuals (age 13-65, fulfilling study inclusion criteria) at high risk of developing psychosis early, and 2) If a graded, multi-modal treatment program will reduce rates of conversion compared to the rates seen in follow-along assessments.
  
  
  CONCLUSIONS
  Positive results could potentially revolutionize therapy by treating risk earlier rather than disorder later and could open a new era of early detection and intervention in psychosis. Negative results will suggest that the potential for psychosis is determined early in life and that research should focus more on genetically linked neurodevelopmental processes. If we can identify people about to become psychotic with high accuracy, we can track them to understand more about how psychosis unfolds. Appropriate intervention at this stage could also prevent or delay the onset of psychosis and/or subsequent deterioration, i.e., social and instrumental disability, suicide, aggressive behavior, affective- and cognitive deficits.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN20328848 . Registered 02 November 2014.
authors.affiliation: Psychiatric Division, Stavanger University Hospital, TIPS- Centre for Clinical Research in Psychosis, Armauer Hansensvei 20, N-4011, Stavanger, Norway. inge.joa@sus.no.|Network for medical sciences, University of Stavanger, 4036, Stavanger, Norway. inge.joa@sus.no.
authors.forename: Inge
authors.initials: I
authors.lastname: Joa
authors.affiliation: Psychiatric Division, Stavanger University Hospital, TIPS- Centre for Clinical Research in Psychosis, Armauer Hansensvei 20, N-4011, Stavanger, Norway. jens.petter.gisselgard@sus.no.
authors.forename: Jens
authors.initials: J
authors.lastname: Gisselgård
authors.affiliation: Psychiatric Division, Stavanger University Hospital, TIPS- Centre for Clinical Research in Psychosis, Armauer Hansensvei 20, N-4011, Stavanger, Norway. kolbjorn.selvag.bronnick@sus.no.|Network for medical sciences, University of Stavanger, 4036, Stavanger, Norway. kolbjorn.selvag.bronnick@sus.no.
authors.forename: Kolbjørn
authors.initials: K
authors.lastname: Brønnick
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT, USA. thomas.mcglashan@yale.edu.
authors.forename: Thomas
authors.initials: T
authors.lastname: McGlashan
authors.affiliation: Psychiatric Division, Stavanger University Hospital, TIPS- Centre for Clinical Research in Psychosis, Armauer Hansensvei 20, N-4011, Stavanger, Norway. jojo@sus.no.|Network for medical sciences, University of Stavanger, 4036, Stavanger, Norway. jojo@sus.no.
authors.forename: Jan Olav
authors.initials: JO
authors.lastname: Johannessen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000502:physiology; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D042241:Early Diagnosis; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods*; D062706:Prodromal Symptoms; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000178:diet therapy* / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D015525:Fatty Acids, Omega-3