7 For the two early intervention studies, two groups of atrisk persons are selected from the larger group of persons referred to the early-recognition centers, according to their presumed prodromal stage. Based on previous longitudinal observations, an “early initial
prodromal stage” is assumed in case subjects report predictive Inhibitors,research,lifescience,medical basic symptoms in the ERI8 or in case they have a first-degree relative with schizophrenia and show a marked decline in global functioning. “Late initial prodromal stages” are defined by the occurrence of brief limited intermittent psychotic symptoms (BLIPS) or by attenuated positive symptoms. Persons at risk for psychosis in the early prodromal state are included into an early intervention study examining the effects of a newly developed cognitivebehavioral therapy (CBT) strategy for prodromal persons, which
is compared with clinical management, within a randomized control design over a 24-month Inhibitors,research,lifescience,medical period.9-10 Persons in the late prodromal state of psychosis are included into a second Inhibitors,research,lifescience,medical early intervention study, which compares the effects of atypical antipsychotic medication with amisulpride in combination with clinical management (supported by crisis intervention or family counseling in case of need, but no regular psychotherapy) to such clinical management alone.11 This is a phase-Ill study with an open-label, randomized parallel design, with a treatment period of 2 Inhibitors,research,lifescience,medical years. Effects
of both studies will be evaluated with regard to improvement of prodromal symptoms, prevention of social decline, and suppression, or at least, delay, of progression to psychosis. Preliminary results of both studies are encouraging, indicating a benefit for at-risk persons treated with CBT or amisulpride, respectively, Inhibitors,research,lifescience,medical compared with the control treatments with regard to these outcome variables. Should these trends be validated in the final analyses, new the use of early recognition and early intervention strategies as developed within the GRNS would be an important, step in the management, of developing psychosis. Example II: acute and long-term treatment in first-episode schizophrenia Though a number of studies have shown advantages of “atypical” second-generation antipsychotics compared with conventional antipsychotics in acute treatment (for review see ref 12) as well as in long-term treatment, of schizophrenia (for review see ref 13) it is still under debate whether these results may be biased by the high dosages of conventional antipsychotics selleck inhibitor usually used in these studies.