[Early detection and early intervention in first episode psychosis]

The onset of schizophrenic disorders generally occurs in late adolescence/early adulthood. However, in 75% of the cases, the onset is preceded by a prodromal stage. Subjects concerned by these prodromal symptoms are defined at "high risk" for psychosis (30% of conversion to psychosis in the next year). Early detection programs aim at improving the recognition of the prodromal symptoms in order to develop appropriate early interventions that will delay or prevent conversion to psychosis or reduce the duration of untreated psychosis (DUP). Atypical antipsychotics are not recommended when psychotic symptoms are only attenuated, while they must be rapidly prescribed when a franc psychotic episode is present. Early identification of patients with schizophrenia is a general practitioners' task provided that they can rely on a supportive specialized psychiatric team. Early intervention should be based on a comprehensive assessment of the subject, in order to propose personalized care that include cognitive therapy, psycho-education, and treatment of associated disorders (depression, substance abuse). The reduction of duration of untreated psychosis will also require sensibilization campaigns in the community with the hope to improve access to care and service delivery.