Prevention and Early Intervention for Psychotic Disorders

Psychotic disorders typically emerge in late adolescence or early adulthood and carry a high burden of chronic disability and social impairment. Prevention and early intervention efforts aim to identify individuals in a prodromal or clinical high-risk state before the onset of a full-blown psychotic episode. Central to this endeavour are clinical staging models that map symptom progression, combined with systematic screening in community and youth mental health settings. Interventions range from low-intensity psychosocial approaches—such as psychoeducation, family support and cognitive-behavioural therapies—to targeted pharmacological or nutraceutical treatments for individuals at ultrahigh risk. Early engagement and shared decision-making foster adherence, while digital platforms and mobile monitoring tools enhance real-time risk assessment. Biomarker research—including neuroimaging, electrophysiology and blood-based signatures—promises more precise stratification of risk and treatment response. Despite advances, heterogeneity in risk trajectories and variable access to specialised services remain key challenges. Coordinated, transdiagnostic frameworks that integrate emerging scientific insights with community-based delivery models are essential to translate prevention science into reductions in transition rates and improvements in long-term functional outcomes.

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Prevention and Early Intervention for Psychotic Disorders publication trend

The graph below shows the total number of articles in prevention and early intervention for psychotic disorders across all publications each year (not limited to Nature Index journals).

Technical terms

Clinical high risk (CHR-P): A symptomatic state characterised by attenuated or brief psychotic experiences and functional decline, indicating elevated risk of transition to full psychosis. Ultrahigh risk (UHR): A subset of CHR-P defined by more stringent criteria, including brief or intermittent psychotic symptoms or marked genetic risk plus functional deterioration. Prodromal phase: The period preceding first-episode psychosis, marked by subtle behavioural changes, cognitive difficulties and emerging subthreshold symptoms. Transition to psychosis: The onset of sustained, clinically significant psychotic symptoms meeting diagnostic thresholds for a psychotic disorder. Cognitive-behavioural case management (CBCM): A structured psychosocial intervention combining cognitive-behavioural techniques with case management to address symptoms and social functioning. Duration of untreated psychosis (DUP): The time interval between the emergence of first psychotic symptoms and the initiation of appropriate treatment, inversely related to long-term outcomes.

References

1. A Sequential Adaptive Intervention Strategy Targeting Remission and Functional Recovery in Young People at Ultrahigh Risk of Psychosis. JAMA Psychiatry (2023).
2. Review: Efficacy of preventative interventions for children and adolescents at clinical high risk of psychosis – a systematic review and meta‐analysis of intervention studies. Child and Adolescent Mental Health (2024).
3. Shared Decision Making With Young People at Ultra High Risk of Psychotic Disorder. Frontiers in Psychiatry (2021).
4. Advances in clinical staging, early intervention, and the prevention of psychosis. F1000Research (2019).
5. Clinical High-Risk for Psychosis (CHR-P) circa 2024: Synoptic analysis and synthesis of contemporary treatment guidelines. Asian Journal of Psychiatry (2024).