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BMC Psychiatry

, 15:89

Psychotic disorders


BackgroundEvidence has been accumulating that it may be possible to achieve prevention in psychotic disorders. The aim of the Prevention Of Psychosis POP study is to reduce the annual incidence of psychotic disorders in a catchment area population through detection and intervention in the prodromal phase of disorder. Prodromal patients will be recruited through information campaigns modelled on the Scandinavian early Treatment and Intervention in Psychosis TIPS study and assessed by low-threshold detection teams.

Methods-DesignThe study will use a parallel control design comparing the incidence of first episode psychotic disorders between two Norwegian catchment areas with prodromal detection and treatment Stavanger and Fonna with two catchment areas without a prodromal intervention program Bergen and Østfold. The primary aim of the current study is to test the effect of a Prodromal Detection and Treatment program at the health care systems level. The study will investigate: 1 If the combination of information campaigns and detection teams modelled will help in identifying individuals age 13–65, fulfilling study inclusion criteria at high risk of developing psychosis early, and 2 If a graded, multi-modal treatment program will reduce rates of conversion compared to the rates seen in follow-along assessments.

DiscussionPositive results could potentially revolutionize therapy by treating risk earlier rather than disorder later and could open a new era of early detection and intervention in psychosis. Negative results will suggest that the potential for psychosis is determined early in life and that research should focus more on genetically linked neurodevelopmental processes.

If we can identify people about to become psychotic with high accuracy, we can track them to understand more about how psychosis unfolds. Appropriate intervention at this stage could also prevent or delay the onset of psychosis and-or subsequent deterioration, i.e., social and instrumental disability, suicide, aggressive behavior, affective- and cognitive deficits.

Trial registrationCurrent Controlled Trials ISRCTN20328848. Registered 02 November 2014.

KeywordsPsychosis Schizophrenia Prodromal Ultra-high risk Early detection AbbreviationsUHRUltra High Risk

APSAttenuated Positive Symptom

GRDGenetic Risk and Deterioration

CBTCognitive Behavioral Therapy

RCTRandomized Controlled Study

SCID-i-PStructured clinical interview for DSM IV Axis I Disorders

SIPSStructured Interview for Prodromal Syndromes

PDTProdromal Detection and Treatment

TIPSTreatment and Intervention in Psychosis

CAARMSComprehensive Assessment of At-Risk Mental States

NAPLSNorth American Prodromal Longitudinal Study

CBTCognitive Behavioral Therapy

GPGeneral Practitioner

FEPFirst Episode Psychosis

PANSSPositive and Negative Symptom Scale

fMRIFunctional Magnetic Resonance Imaging

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Autor: Inge Joa - Jens Gisselgård - Kolbjørn Brønnick - Thomas McGlashan - Jan Olav Johannessen


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