title: Early interventions in risk groups for schizophrenia: what are we waiting for?
abstract: Intervention strategies in adolescents at ultra high-risk (UHR) for psychosis are promising for reducing conversion to overt illness, but have only limited impact on functional outcome. Recent studies suggest that cognition does not further decline during the UHR stage. As social and cognitive impairments typically develop before the first psychotic episode and even years before the UHR stage, prevention should also start much earlier in the groups at risk for schizophrenia and other psychiatric disorders. Early intervention strategies could aim to improve stress resilience, optimize brain maturation, and prevent or alleviate adverse environmental circumstances. These strategies should urgently be tested for efficacy: the prevalence of ~1% implies that yearly ~22 in every 100,000 people develop overt symptoms of this illness, despite the fact that for many of them-e.g., children with an affected first-degree family member or carriers of specific genetic variants-increased risk was already identifiable early in life. Our current ability to recognize several risk groups at an early age not only provides an opportunity, but also implies a clinical imperative to act. Time is pressing to investigate preventive interventions in high-risk children to mitigate or prevent the development of schizophrenia and related psychiatric disorders.
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht, the Netherlands.
authors.forename: Iris E
authors.initials: IE
authors.lastname: Sommer
authors.affiliation: Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California , Los Angeles, CA, USA.
authors.forename: Carrie E
authors.initials: CE
authors.lastname: Bearden
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht, the Netherlands.
authors.forename: Edwin
authors.initials: E
authors.lastname: van Dellen
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht, the Netherlands.
authors.forename: Elemi J
authors.initials: EJ
authors.lastname: Breetvelt
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht, the Netherlands.
authors.forename: Sasja N
authors.initials: SN
authors.lastname: Duijff
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht, the Netherlands.
authors.forename: Kim
authors.initials: K
authors.lastname: Maijer
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University , Maastricht, The Netherlands.
authors.forename: Therese
authors.initials: T
authors.lastname: van Amelsvoort
authors.affiliation: Department of Psychiatry, Academic Psychiatric Centre, AMC , Amsterdam, The Netherlands.
authors.forename: Lieuwe
authors.initials: L
authors.lastname: de Haan
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, USA.
authors.forename: Raquel E
authors.initials: RE
authors.lastname: Gur
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, School of Medicine, Universidad Complutense , Madrid, Spain.
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, School of Medicine, Universidad Complutense , Madrid, Spain.
authors.forename: Covadonga M
authors.identifier: 0000-0001-8538-3175
authors.initials: CM
authors.lastname: Díaz-Caneja
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht, the Netherlands.
authors.forename: Christiaan H
authors.initials: CH
authors.lastname: Vinkers
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht, the Netherlands.
authors.forename: Jacob As
authors.initials: JA
authors.lastname: Vorstman