Early recognition and intervention - The key to success in the treatment of schizophrenia?

Schizophrenia is possibly the single most costly disorder in psychiatric or somatic medicine, despite a relatively low yearly incidence of about 10/10 0 000/ year. In many cases it is a life-long disabling disorder. Available treatments, including medication, psychotherapy and family treatments are l argely palliative and seem to be of only limited value. This may be due to an apparent delay in providing treatment early in the course of the illness . Schizophrenia can be regarded as a disorder that develops in stages: premor bid, prodromal and psychotic. Research over the last few years indicates th at early treatment for schizophrenia may improve the course of the disorder . Projects aimed at intervening in the prodromal phase of the disorder have s hown that it may be possible to reduce the incidence in a catchment area (B uckingham, UK), or prevent the conversion of prodromal cases into fulminate psychosis (Melbourne. Australia). In Norway, the Early Treatment and Intervention in Psychosis (TIPS) project demonstrated that it was possible to reduce the duration of untreated psyc hosis within a catchment area from a mean of 114 weeks to 26 weeks, and thu s dramatically reduce the total period of psychosis. There are also indicat ions that earlier detection results in patients who present with less sever e psychopathology. Earlier detection is possible through information campaigns which enhance t he public's knowledge about serious psychiatric disorders, and aim to reduc e the stigma associated with this disorder and change help-seeking behavior . Earlier intervention requires easy access to psychiatric health services, and early, comprehensive treatment programs. Early detection and intervention can be managed successfully ensuring patie nts are provided with treatment at an earlier point in the development of t he illness. Such programs are relatively inexpensive, since it is a questio n of organizing the health services in a way that meets the population's ne eds.