As a result, this group has conducted much of the groundbreaking conceptual and early research that jump-started the field. Although new trials are underway in the PACE clinic, to date, the major treatment findings have resulted from the original randomized clinical trial (RCT)47 in which a study group receiving low-dose

risperidone combined with cognitive behavioral therapy (CBT) was compared with a “needs-based” treatment control group. This was the first randomized, controlled intervention trial conducted in prodromal individuals. Patients were between 14 and 30 years and met any one or more of three criteria, considered to define “ultra high-risk” (UHR): Attenuated psychotic symptoms defined as Inhibitors,research,lifescience,medical subthreshold attenuated positive symptoms that do not reach psychotic Inhibitors,research,lifescience,medical intensity yet represent distinct departures from normal experience. Brief limited intermittent psychotic symptoms (BLIPS), defined as the presence of infrequent or intermittent psychotic

level symptoms of a IWR-1 molecular weight duration < 1 week, that spontaneously remit. Trait and state risk factors defined as the presence of psychosis or schizotypal personality disorder in a firstdegree Inhibitors,research,lifescience,medical relative or schizotypal personality disorder in the identified patient, and a decrease in functioning that is sustained for 1 month. Conversion to psychosis, the outcome of interest, is defined as meeting the criteria for a brief limited psychosis for longer than 1 week. The trial compared a Inhibitors,research,lifescience,medical needs-based intervention (NBI, the control condition) with a specific preventive intervention (SPI). The NBI consisted of a focused supportive psychosocial intervention.

The SPI combined 1 to 2 mg risperidone with a modified CBT program, in addition to focused supportive intervention. Interventions were provided for 6 Inhibitors,research,lifescience,medical months, after which patients in both groups received 6 months of NBI. Treatment was augmented with antidepressants (ADs) and benzodiazepines when necessary in both groups. Fifty-nine high-risk subjects were randomized and some differences were found between the groups in terms of use of ADs (NBI>SPI) and number of therapy sessions received (SPI>NBI). At 6 months, the rate of conversion to psychotic illness (not necessarily schizophrenia) was significantly higher in the control (NBI) group (36%, 10/28) than the early intervention (SPI) group (10%, 3/31). However, this difference did not hold Cytidine deaminase up at the 1-year mark (36% NBI versus 19% SPI). If adherence to medication was considered, those who were fully compliant with the intervention procedures in the SPI group were significantly less likely to convert than those in the NBI group at both 6 and 12 months. However, these findings are not conclusive since more than half of the subjects in the SPI group were less than fully compliant with medication.