Prevention of the first episode of psychosis

Long a desired goal but increasingly a focus of research on clinical practice, prevention of psychosis has emerged as one of the most promising and effective areas of investigational interest and effort in psychiatry. Spurred by long-term studies that have associated outcome with duration of untreated psychosis, current research is focused on improving the accuracy of prediction based on clinical and neurocognitive measures and on refining treatments of the earliest symptoms of the psychoses. Both efforts are bearing success, although there remains ambiguity as to the most effective preventive interventions. This article reviews the leading studies of, and remaining issues for, this important enterprise.