[Early determination of schizophrenia--is primary prophylaxis possible?]

Early intervention is a new and potentially promising strategy for the treatment of schizophrenia.

The article reviews the recent literature on how primary prevention can be conceptualised and what strategies may be effective.

Primary prevention of schizophrenia means that treatment is given during the prodromal or prepsychotic phase. The DSM-III-R criteria for prodromal symptoms are too unspecific to be used to target such prevention. The basic symptom model seems to give the best concepts for primary prevention. Three types of prepsychosis are defined: attenuated positive symptoms, brief intermittent psychotic symptoms, and genetic risk with recent psychosocial deterioration. Preliminary findings indicate that 33-70% of those being diagnosed with prepsychosis develop psychosis within the first year of follow-up. Psychiatric health services should be organised in such a way that patients are given treatment as soon as possible after the onset of psychosis.