| Is early détection and secondary prevention of schizophrenia a realistic goal? |
| • Can premorbid and prodromal manifestations of schizophrenia be utilized for early detection and intervention? |
| • Can early intervention delay the onset of the disease, ameliorate its manifestation, or improve the long-term outcome? |
| • Do the risks for false-positive identification and stigmatization justify the potential benefits? |
| Rational for early detection and treatment |
| • The lag-time between the first manifestation of schizophrenia and the first treatment contact ranges between a few month and a few years |
| • First-episode patients treated earlier rather than later had a faster remission |
| • Patients whose illness started after neuroleptics were available on a large scale (1970) have a better long-term outcome |
| • Because schizophrenia has its onset at a critical age for social and vocational development, any delay in onset or amelioration of symptoms carries a large impact in outcome |
| Minimal requirements for early treatment with antipsychotic drugs |
| • Predictive test |
| - Easy applicable, reliable, specific for the illness being treated |
| • Treatment |
| - Good risk-benefit ratio |
| - Minimal and reversible adverse effects |
| - Low cost |
