Psychological interventions in people at-risk for first episode psychosis

Indicated prevention in individuals at clinical high risk for first episode psychosis is hoped to delay the onset of the disorder or even prevent the transition to full-blown psychosis. Remission of at-risk symptoms, psychosocial functioning and quality of life are secondary outcomes. According to current evidence cognitive behavioral therapy can be considered the best evaluated stand alone therapy approach for the prevention of psychosis. The treatment of persons at risk for first episode psychosis is associated with the risk of exposing falsely identified persons to potential side effects; therefore, treatment with the best risk-benefit ratio should be chosen. Consequently, monitoring within specialized early recognition centers should be considered first, followed by a customized psychoeducation. The data on psychoeducation of people at risk for psychosis are encouraging but still not sufficient. Methodological issues and differences of the evaluated approaches are discussed.