Several important paradigm shifts have occurred in the field of schizophrenia treatment, including an increased focus on early detection, the development of preemptive interventions, and the view of schizophrenia as a neurodevelopmental disease characterized by decreased efficiency and abnormal connectivity in cortical and subcortical neural networks. In this review article, we will briefly describe some of the neural impairments that contribute to the development of schizophrenia, with an emphasis on the impact of stress and trauma on cognitively vulnerable neural systems. We will then present current data on two behavioral interventions that target these critical risk factors and that aim to preempt the onset of schizophrenia in vulnerable individuals or improve the clinical course in recent onset schizophrenia: cognitive therapy and computerized cognitive training.

The journey described by participants assessed as being at risk of developing psychosis provides further insight into how persons make sense of their experiences from a qualitative 'insider' perspective. The findings are discussed in relation to the existing literature relating to the early detection and intervention of psychosis and clinical implications are identified.

New methods in genetics research, such as linkage disequilibrium score regression (LDSR), quantify overlap in the common genetic variants that influence diverse phenotypes. It is becoming clear that genetic effects often cut across traditional diagnostic boundaries. Here, we introduce genetic correlation analysis (using LDSR) to a nongeneticist audience and report transdisciplinary discoveries about schizophrenia. This analytical study design used publically available genome wide association study (GWAS) data from approximately 1.5 million individuals. Genetic correlations between schizophrenia and 172 medical, psychiatric, personality, and metabolomic phenotypes were calculated using LDSR, as implemented in LDHub in order to identify known and new genetic correlations. Consistent with previous research, the strongest genetic correlation was with bipolar disorder. Positive genetic correlations were also found between schizophrenia and all other psychiatric phenotypes tested, the personality traits of neuroticism and openness to experience, and cigarette smoking. Novel results were found with medical phenotypes: schizophrenia was negatively genetically correlated with serum citrate, positively correlated with inflammatory bowel disease, and negatively correlated with BMI, hip, and waist circumference. The serum citrate finding provides a potential link between rare cases of schizophrenia (strongly influenced by 22q11.2 deletions) and more typical cases of schizophrenia (with polygenic influences). Overall, these genetic correlation findings match epidemiological findings, suggesting that common variant genetic effects are part of the scaffolding underlying phenotypic comorbidity. The “genetic correlation profile” is a succinct report of shared genetic effects, is easily updated with new information (eg, from future GWAS), and should become part of basic disease knowledge about schizophrenia.

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Aim To describe the development of a sustainable community early psychosis program created through an academic–community partnership in the USA to other parties interested in implementing early psychosis services founded upon evidence based practices within community settings. Method The service was developed around a sustainable core of key components, founded upon evidence based practice, with additional flexible elements that could be adapted to the needs of the individual commissioning county. This article describes the ways in which funding was sourced and secured as well as the partnerships developed through this process. Results Successful development of the Prevention and Recovery from Early Psychosis (PREP) program in San Francisco County, California. PREP clinicians have received extensive training in the evidence-based approaches that are available through the program and treated 30 clients and their families in the first year of operation. Conclusions Development of a sustainable community program of this type in a non-universal health care setting which is historically seen as non-integrated required extensive partnering with agencies familiar with local resources. Implementation of the community-academic partnership bridged the gap between research and practice with successful integration of fidelity practice at the community level. The community partners were effective in sourcing funding and allocating resources while the academic side of the partnership provided training in evidence-based models and oversight of clinical implementation of the model. Stringent evaluation of the impact of the service is our next focus