Early Intervention in Psychosis: A Brief Narrative Review

Background: Schizophrenia and other psychotic spectrum disorders cause significant impairment, and for long, therefore, the approach of management was early recognition and intervention for first-episode psychosis (FEP). As it became apparent that nonspecific symptoms precede full blown psychosis, it led to a shift towards early identification of prodrome and intervention to improve outcomes. Purpose: This narrative review discusses the current interventions aimed at preventing or delaying the onset of psychosis in high-risk individuals. It explored the various evidence bases for the role of both pharmacological and psychosocial intereventions, such as low-dose antipsychotics, cognitive behavioral therapy (CBT), family interventions, as well as emerging strategies like physical exercise, virtual reality, smartphone-based apps and neuromodulation. The review also discusses clinical challenges in identifying at-risk states as well as its treatment. Collection and Analysis (Results): Existing treatments show varying efficacy in preventing the onset of psychosis. While low-dose antipsychotics and CBT have demonstrated some success in reducing conversion rates to psychosis, long-term outcomes remain inconsistent. Emerging interventions offer promising potential but require further research. A multimodal approach, as demonstrated by programs like NAVIGATE, has proven effective in supporting functional recovery in individuals with FEP. Conclusion: Early identification and intervention in individuals at risk of psychosis are vital for improving outcomes. While current treatment options show potential, there are challenges, such as the wide variation in presenting symptoms and the need for individualised care. Clinical staging and transdiagnostic models could offer promising directions for developing more targeted interventions. However, more research is required to improve treatment strategies.