9. Early Psychosis: expanding the market for preventive medicine

Detection and intervention programmes are now being implemented in various countries which extend the definition of schizophrenia to include a ‘pre-psychotic’ phase. Neuroleptic medication is being prescribed in the belief that it can prevent the development of psychosis in people who are merely thought to be ‘at-risk’.[1] The pre-psychotic signs of schizophrenia are usually referred to as early psychosis or as prodromal symptoms of schizophrenia.[2] These pre-psychotic symptoms, however, are only tentative, and researchers themselves sometimes describe them as being ‘putative’.[3]

Promoters of the concept see pre-psychosis detection and intervention as a form of preventive medicine. They argue that if the incidence of schizophrenia can be reduced by early identification and treatment, as is the case for some somatic diseases, community benefits will follow such as cost savings and avoidance of personal trauma and family disruption.[4]

[1] A R. Yung et al., ‘Monitoring and care of young people at incipient risk of psychosis’, p. 300.

[2] Tor K. Larsen and Stein Opjordsmoen, ‘Early identification and treatment of schizophrenia: conceptual and ethical considerations’, pp. 371–81.

[3] Alison R. Yung and Patrick D. McGorry, ‘The Prodromal Phase of First-Episode Psychosis: Past and Current Conceptualisations’, pp. 353–70.

[4] Chris Jackson and Max Birchwood, ‘Early intervention in psychosis: Opportunities for secondary prevention’, pp. 487–502.