The Psychosis High-Risk State

Abstract

The disabling nature and costly impact of mental disorders, such as schizophrenia, can cause significant burden to both person and society. It is also indicated that the negative outcomes associated with psychosis may, in part, be due to the delayed detection and initiation of treatment. Preventative interventions in several arenas of medicine have advanced; however have only come to the fore in psychiatry in the last two decades. It was long-known that a preclinical phase preceded psychosis, now commonly termed as ultra high-risk (UHR) status.The advent of specialized early intervention services provided the cornerstone in taking a preventative and timely endeavor to maximize the chance of positive outcomes in psychosis.Despite the potential, the current state of the UHR concept lacks consensus in how at-risk individuals should be approached. This chapter aims to provide an overview of how preventative medicine can intersect with psychiatry by focusing on the psychosis high risk state. It describes the current criteria and screening procedures used to prospectively detect UHR individuals, as well as discussing the validity of these tools. Whilst advocating the benefits of focused interventions, this chapter also recognizes current challenges and the controversy that leaves the psychosis high risk state on fertile ground for wavering opinions.The chapter concludes with an exploration and discussion that proposes an improved conceptualization of the high risk state and how this can direct intervention, as well as suggesting future lines of research in this area.2

Coping strategies in individuals at ultra‐high risk of psychosis: A systematic review

“…Those identified as ultra‐high risk might have different clinical outcomes, including depression (Rutigliano, Manalo, & Fusar‐Poli, ). Since dysfunctional coping has been associated with depression, interventions that challenge core beliefs and coping strategies in this area might be more appropriate for this population (Schmidt et al, ).…”