Preventive strategies can be divided into universal, selective and indicated prevention and early intervention. Universal interventions are directed to the general population.

Selective approaches are targeted at people who have risk factors for an illness, but who do not show any current signs. Indicated approaches target high risk individuals with minimal signs or symptoms foreshadowing mental disorder, but who do not meet diagnostic levels at the current time.

Early intervention involves treating those with already diagnosable disorder in a timely and optimal manner aiming to decrease the severity of the illness, and reduce secondary morbidity. Although universal and selective interventions are not yet viable strategies, indicated prevention and early intervention are now realistic possibilities in schizophrenia. Development of methods to identify those at risk of psychosis continues to evolve.

Promising results in the prevention and delay of transition to psychotic disorder from high risk state have been found. Early intervention in schizophrenia, including promotion of early help-seeking, has been shown to reduce the duration of untreated psychosis, which is known to be associated with poor outcome in schizophrenia.

Early intervention programmes which optimise the care of the first episode have been shown to produce better outcomes than routine management.

Authors: A R Yung, E Killackey, S E Hetrick, A G Parker, F Schultze-Lutter, J Klosterkoetter, R Purcell, P D Mcgorry

The Prevention of Schizophrenia: What Interventions Are Safe and Effective?

Obstetric complications appear to increase the risk of developing schizophrenia, and post-World War II improvements in obstetric care may have contributed to a decline in the incidence of the illness in the developed world.

Educating providers and consumers of psychiatric and obstetric services about the risk of obstetric complications in increasing the risk of schizophrenia could bring about a further small decrease in the incidence of the illness, safely and at low cost. On the other hand, attempts to prevent the occurrence of schizophrenia by treating people who manifest highrisk indicators prior to the development of the illness have a low probability of success and a high probability of unintended negative consequences.

Early intervention with people who have developed the full schizophrenia syndrome is likely to have few negative effects and may yield benefits, although it is not yet clear that it will.

How to Lower Your Risk for Schizophrenia

 
• Don’t use street drugs, and moderate any use of alcohol
 
• Make an ongoing effort to develop your social skills as much as you can
 
• Avoid social isolation
 
• Make an ongoing effort to maintain friendships with adults
 
• Make an extra effort to learn positive perspectives on the world
 
• Make extra effort to learn how to deal with stress and anxiety
 
• Seek Help from Qualified Psychologists and Psychiatrists if you have problems coping

Keywords: Schizophrenia / prevention / obstetric complications / early intervention / risk assessment

Richard Warner, M.B., D.P.M., Medical Director
Mental Health Center of Boulder County, and Clinical Professor of Psychiatry and Adjunct Professor of Anthropology, University of Colorado Boulder, CO

R. Warner, Mental Health Center of Boulder County, 1333 Iris Avenue, Boulder, CO 80304; e-mail: .(JavaScript must be enabled to view this email address)