A neurodevelopment and neuroplasticity-based framework for early intervention in psychotic disorders

Area of Science:

• Psychiatry and Neuroscience
• Clinical Psychology

Background:

• Growing interest in early intervention for psychotic disorders.
• Clinical staging model widely used for early intervention rationale.
• Clinical staging in medicine is valuable for progressive disorders.

Discussion:

• The clinical staging model for psychosis is proposed without confirming schizophrenia as primarily progressive.
• Cross-sectional data supporting staging may be affected by sampling bias, unreliable symptom assessment, and false positives.
• Longitudinal neurobiological studies do not convincingly support primarily progressive pathology in schizophrenia.

Key Insights:

• Schizophrenia progression is better understood as neuroplastic changes.
• These changes result from interactions between developmental pathology and environmental stimuli.
• Current evidence does not support schizophrenia as a primarily progressive disorder.

Outlook:

• Proposes an alternative rationale for early and continuous intervention.
• Targets neurodevelopmental abnormalities and neuroplastic changes.
• Includes medical and psychological comorbidities in intervention strategies.