Is early detection feasible and useful as a public health strategy for the management of first-episode psychosis?

Abstract

There is enough evidence to support the fact that important neurobiological and psychosocial changes take place during the first-episode psychosis, that may have a substantial effect on the future outcomes, particularly on the degree of global functioning and the levels of disability ("critical period hypothesis"). In turn, there is evidence demonstrating that the shorter the period a psychosis remains untreated during the first episode, the better the prognosis. The latter has prompted the development of interventions allowing an earlier detection of psychosis from the very first onset of the first symptoms. The results - all obtained in developed countries - show a remarkable improvement of the duration of untreated psychosis, in the recovery and prognosis of the disease, as well as in the decrease of the associated risks (such as drug abuse and suicide). Such background has powered the WHO to advise the countries to adopt policies directed towards the early detection of people with first-episode psychosis.