Is pre-psychotic intervention of schizophrenia realistic ?

Schizophrenia is a serious disorder that often affects young people in their early twenties. The outcome is often poor, associated costs and burdens are extensive. Almost 15% of schizophrenics end up with frequent admission and require long-term residential care (1). Recently, the idea of early detection and intervention has been launched as a new and promising approach. The starting point for consideration regarding early intervention strategies is the observation that most patients who develop schizophrenia have had a period with non-specific, non-psychotic prodormal symptoms before the onset of psychosis (2,3). The prodormal period has been reported to last, on average, 1 – 2 years. Another finding across studies in that the period from onset of a manifest psychosis to onset of adequate treatment (duration of untreated psychosis DUP) is long. The mean duration of DUP is 1-2 years with a median of approximately 26 weeks. The majority of studies show a statistically significant correlation between long DUP and poor outcome (4,5), although others have not found the correlation (6,7).