ReviewPsychological medicine2019
Four reasons why early detection centers for psychosis should be renamed and their treatment targets reconsidered: we should not catastrophize a future we can neither reliably predict nor change.
Review in Psychological medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Self-stigma in Serious Mental Illness: A Systematic Review of Frequency, Correlates, and Consequences.Schizophrenia bulletin · 2021Pooled it
- Cross-linguistic benchmarking of NLP metrics for psychosis research.NPJ digital medicine · 2026Article
- Availability and effectiveness of multicomponent interventions for early psychosis in 20 low-income and middle-income countries: a systematic review.EClinicalMedicine · 2026Article
- Preferences for Psychological Therapy or Support Within an ARMS Psychological Therapies Trial: The Importance of Targeted Intervention for Unusual Sensory Experiences.Early intervention in psychiatry · 2025Article
- Clinical utility of the at-risk for psychosis state beyond transition: A multidimensional network analysis.European child & adolescent psychiatry · 2025Article
- Participatory research with co-researchers with lived experience of psychosis high risk states.Frontiers in psychiatry · 2025Article
- Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024Article
- Identification of distinct clinical profiles and trajectories in individuals at high risk of developing psychosis: A latent profile analysis of the north American prodrome longitudinal study consortium-3 dataset.Early intervention in psychiatry · 2024Article
- A Latent Profile Analysis of Emotion Regulation in Relation to Distress of Symptoms in Youth with Prodromal Psychotic Symptoms.Behavioral sciences (Basel, Switzerland) · 2024Article
- An exploratory study of psychosis risk factors in individuals who are referred but do not meet criteria for an early intervention in psychosis service.BJPsych open · 2024Article
- Duration of Untreated Illness in Patients with Obsessive-Compulsive Disorder and Its Impact on Long-Term Outcome: A Systematic Review.Journal of personalized medicine · 2023Review
- Validation of natural language processing methods capturing semantic incoherence in the speech of patients with non-affective psychosis.Frontiers in psychiatry · 2023Article
- Mind the (transition) gap: Youth mental health-oriented early intervention services to overcome the child-adolescent vs. adult hiatus.Frontiers in psychiatry · 2022Article
- What makes the psychosis 'clinical high risk' state risky: psychosis itself or the co-presence of a non-psychotic disorder?Epidemiology and psychiatric sciences · 2021Article
- Preventive psychiatry: a blueprint for improving the mental health of young people.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2021Article
- Most at-risk individuals will not develop a mental disorder: the limited predictive strength of risk factors.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2021Article
- Neurocognition and Social Cognition- Possibilities for Diagnosis and Treatment in Ultra-High Risk for Psychosis State.Frontiers in psychiatry · 2021Review
- Prevention of psychosis: moving on from the at-risk mental state to universal primary prevention.Psychological medicine · 2021Article
- Psychotic-Like Experiences: A Challenge in Definition and Assessment.Frontiers in psychiatry · 2021Review
- The reality of at risk mental state services: a response to recent criticisms.Psychological medicine · 2021Article
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Since the 1990s, facilities for individuals at putative risk for psychosis have mushroomed and within a very short time have become part of the standard psychiatric infrastructure in many countries. The idea of preventing a severe mental disorder before its exacerbation is laudable, and early data indeed strongly suggested that the sooner the intervention, the better the outcome. In this paper, the authors provide four reasons why they think that early detection or prodromal facilities should be renamed and their treatment targets reconsidered. First, the association between the duration of untreated psychosis and outcome is empirically established but has become increasingly weak over the years. Moreover, its applicability to those who are considered at risk remains elusive. Second, instruments designed to identify future psychosis are prone to many biases that are not yet sufficiently controlled. None of these instruments allows an even remotely precise prognosis. Third, the rate of transition to psychosis in at-risk patients is likely lower than initially thought, and evidence for the success of early intervention in preventing future psychosis is promising but still equivocal. Perhaps most importantly, the treatment is not hope-oriented. Patients are more or less told that schizophrenia is looming over them, which may stigmatize individuals who will never, in fact, develop psychosis. In addition self-stigma has been associated with suicidality and depression. The authors recommend that treatment of help-seeking individuals with mental problems but no established diagnosis should be need-based, and the risk of psychosis should be de-emphasized as it is only one of many possible outcomes, including full remission. Prodromal clinics should not be abolished but should be renamed and restructured. Such clinics exist, but the transformation process needs to be facilitated.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.