This is an important oversight, since these early deficits appear to be most closely associated with the functional disability (ie, inability to work independently, social isolation) that is thought to restrict prognosis more directly than psychosis, in itself.39,40 Thus, a major research goal,

at present not widely recognized, should be to determine whether negative risk factors and deficits can be reduced with early treatment, and, if doing so has in turn the potential to improve functional outcome. Because of the many unresolved issues characterizing the treatment Inhibitors,research,lifescience,medical of the prodromal phase, the questions asked tend to vary widely from site to site. Although the potential for answers is considerable, there are few definitive findings available,41 and the data that do exist are quite variable. Falloon42 conducted the first attempt at prevention using AP medication in Inhibitors,research,lifescience,medical a study in rural Britain. In this project, family practitioners

were educated to identify prodromal individuals using Diagnostic and Statistical Manual Inhibitors,research,lifescience,medical of Mental Disorders, Third Edition, Revised (DSM-III-R) prodromal criteria and to refer these patients to a multidisciplinary early intervention team. Sixteen individuals meeting entry criteria were provided intensive stress management and family psychosocial intervention and were treated with low-dose neuroleptic medication when Inhibitors,research,lifescience,medical necessary The results of these efforts suggested that early intervention reduced conversion rates (compared to those previously recorded in the catchment area), although these findings were not considered Inhibitors,research,lifescience,medical to be conclusive because the study was conducted under uncontrolled conditions. Following Falloon, prodromal programs were established in Melbourne, Australia (Personal Assessment and Crisis Evaluation

[PACE] clinic),37,43 and in the USA in Connecticut (Prevention through Risk Identification, Management, and Education [PRIME] clinic)44 and New York (Recognition and Prevention [RAP] Histamine H2 receptor program),4-6 At present, findings are thus far largely limited to these three original prodromal programs. Although there are some commonalities, each of these programs has adopted different research and treatment AZD8931 strategies. For example, both the McGorry and McGlashan treatment groups (PACE and PRIME clinics) focus on randomized clinic trials. Starting from a very different perspective, Cornblatt et al (RAP program) report findings from a prospective naturalistic study, which is as much concerned with defining risk factors as with treatment.