Preventie van een psychotische aandoening: Rijp voor klinische toepassing?

A growing number of research papers focus on the identification of young individuals meeting 'ultra-high risk criteria' for developing a first episode of psychosis. Intervention in this early phase might possibly prevent or postpone the development of a full-blown psychosis. Different detection and treatment strategies within this target group are being discussed. This is illustrated using three cases. The first is a 20-year-old female with subclinical psychotic symptoms and recent functional decline; however, as her symptoms only presented following drug abuse, she was not considered to be at ultra-high risk for developing a first episode of psychosis. The second case involves a 17-year-old student who did meet at-risk criteria; after seeking help for subclinical psychotic symptoms and increasing social withdrawal behaviour his symptoms decreased with help of CBT. The third case, an 18-year-old male, illustrates that specialized investigation into high-risk symptoms of psychosis are sometimes needed to reveal frank psychotic symptoms.