Treatment of first-episode and prodromal signs

The first episode of psychosis is now recognized as a critical period for effective intervention. There is also convincing evidence demonstrating the superiority of specialized early intervention services in improving short- to medium-term outcomes of the first episode of psychosis compared with standard care. There is now a concerted international research and clinical effort into identifying and treating ‘prodromal’ cases of psychosis. In this article, we describe the three different ways that early intervention can treat first-episode and prodromal cases (prodromal intervention, early detection and effective treatment of the first episode), summarizing the evidence for each of these strategies. We also outline the principles and ‘therapeutic ingredients’ of effective treatment of the first episode of psychosis.