Schizophrenia: Early Recognition and Prevention

Schizophrenia is a heterogenous disorder presenting as episodes of psychosis against a background of cognitive, social, and functional impairments. Schizophrenia, a multifaceted neuropsychiatric disorder, is affecting approximately 1% of the population worldwide. Its onset is the result of a complex interplay of genetic predisposition and environmental factors. The clinical staging model of psychotic disorders implies that early successful treatment may improve prognosis and prevent progression to more severe stages of disorder. So, prevention and early intervention of schizophrenia are correlated with the prodromal phase, especially with “at risk mental state” (ARMS) and the prediction of their transition to a full-blown psychotic disorder. The psychosis prodrome includes nonspecific signs and symptoms (such as depressed mood, anxiety, sleep disturbance, and deterioration in role functioning), “basic symptoms” (thought interference, disturbance of receptive language, and visual perception disturbance), attenuated or subthreshold psychotic symptoms, neurocognitive deficits, and neurobiological changes measured via magnetic resonance imaging (MRI). Increasing improvements in the identification of those truly at “high risk” for psychotic disorder have paved the way of early intervention strategies in this population and increased the possibility of minimizing distress and disability and delaying or even preventing the onset of an evident psychotic disorder. The treatment (antipsychotic medication, psychological and social interventions) for young people who meet ARMS criteria should not only focus on the symptoms that constitute the ARMS criteria but also address the broader range of difficulties with which the young person might present. There are some ethical issues to consider when selecting specific treatment options, and the potential risks of treatment have to be balanced against the potential benefits