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Minerva Psichiatrica 2007 June;48(2):225-36


language: Italian

Early intervention in psychosis: pharmacological and psychosocial treatment

Papili P., Cevenini N., Mori E., Rossi E., Mandelli L., Michetti R., Serretti A., De Ronchi D., Berardi D.

Istituto di Psichiatria P. Ottonello, Bologna


In the last ten years, renewed attention has been paid to intervention in the early phases of psychosis with the aim to improve the prognosis of the disease. Early intervention programmes have been developed on the basis of two critical elements: early identification of subjects at the prodromic stage or with psychosis at the onset, and integrated and specific intervention. The purpose of the present paper is to describe the main pharmacological and psychosocial interventions currently adopted in the treatment of psychosis at its onset and at the prodromic stage, setting out the salient characteristics and putting forward what effectiveness tests are available. The effectiveness of intervention at the prodromic stage is widely debated, considering how difficult it is to identify prodromic symptomatology and how variable the rates of conversion to psychosis are, with a high risk of treating false positives. On the other hand, preliminary studies support the effectiveness of intervention programmes designed specifically for the onset of psychosis in order to improve the clinical and psychosocial prognosis, although at the moment no definitive evidence has been reported in the literature. Further development of research is, therefore, necessary in order to support the stability of positive results in the short term and in the long term and with respect to the patient’s social life and ability to work. In addition, which components of the specific programmes described in the literature are associated with greater clinical effectiveness should be defined in detail.

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