Early detection and treatment delay: implications for outcome in early psychosis

The rapidly growing interest in early psychosis has three preventive foci. The prepsychotic phase is when most psychosocial impairment develops, but t he specifics of treatment remain difficult to research and apply. Although the total duration of untreated illness may be more critical, the duration of untreated psychosis is a more realistic immediate target for strategies of early detection and intervention. The role of duration of untreated psyc hosis as a causal factor influencing outcome remains to be definitively est ablished, but these strategies are well justified on clinical grounds. Fina lly, first-episode psychosis is comparatively more treatment responsive tha n multiepisode psychosis, and intensive phase-specific treatment appears to result in short-term improvements in outcome and cost effectiveness. Curr Opin Psychiatry 13:37-43. (C) 2000 Lippincott Williams & Wilkins.