These important theoretical issues must
be resolved before we can translate the new biological findings into better outcomes for the large numbers of untreated or poorly treated patients suffering from schizophrenia.
Interest in the prodromal stage of schizophrenia has escalated dramatically over the past decade, as evidence has increased suggesting that the Inhibitors,research,lifescience,medical prevention of schizophrenia might be possible with early pharmaco-therapeutic intervention. The prodrome is considered to be the stage of schizophrenia that begins with the first changes in behavior and lasts up until the onset of psychosis.1-3 As defined at present, the prodromal period is highly variable and can last from Inhibitors,research,lifescience,medical weeks to years, although typically it persists for at least a year.1,4 Momentum for the shift in initiating treatment during the prodrome, rather than after the actual onset of DNA Damage inhibitor psychosis, has been provided by the convergence of several developments,
including: (i) increasing support for schizophrenia Inhibitors,research,lifescience,medical as a neurodevelopmentai disorder; (ii) emerging evidence that early treatment improves outcome; and (iii) the introduction of novel antipsychotic medication, potentially providing the tools for preventive intervention. Yet, despite the growing optimism about prevention, little is understood about
the basic characteristics of this phase of the illness. For example, little, if any, previous research has focused on whether the prodrome Inhibitors,research,lifescience,medical is a single clinical entity or, as in the case of full-blown schizophrenia, it is likely to be heterogeneous. In addition, given that adolescents make up a substantial Inhibitors,research,lifescience,medical proportion of the prodromal population, virtually no information is available about the developmental course of the prodrome. Of particular importance, long-term prospective research evaluating the predictive accuracy of prodromal risk factors is only now becoming of widespread interest – suggesting that it may not yet be the time to initiate largescale clinical trials concerned with prevention. In this article, an not overview of the currently available data about the schizophrenia prodrome will be presented, followed by a discussion of the major questions still to be answered and a brief description of a relatively new project ongoing at Hillside Hospital in New York – the Recognition and Prevention (RAP) program designed to provide substantial groundwork for future prevention trials. Theory and background Neurodevelopmentai model of schizophrenia A neurodevelopmentai view of schizophrenia has provided the primary conceptual underpinnings of the movement toward early intervention and prevention.