Primary prevention of psychosis through interventions in the symptomatic prodromal phase, a pragmatic Norwegian Ultra High Risk study
Original version
Joa, I. et al. (2015) Primary prevention of psychosis through interventions in the symptomatic prodromal phase, a pragmatic Norwegian Ultra High Risk study. BMC Psychiatry 10.1186/s12888-015-0470-5Abstract
Background: Evidence has been accumulating that it may be possible to achieve prevention in psychotic
disorders. The aim of the Prevention Of Psychosis (POP) study is to reduce the annual incidence of psychotic
disorders in a catchment area population through detection and intervention in the prodromal phase of disorder.
Prodromal patients will be recruited through information campaigns modelled on the Scandinavian early Treatment
and Intervention in Psychosis (TIPS) study and assessed by low-threshold detection teams.
Methods/Design: The study will use a parallel control design comparing the incidence of first episode psychotic
disorders between two Norwegian catchment areas with prodromal detection and treatment (Stavanger and
Fonna) with two catchment areas without a prodromal intervention program (Bergen and Østfold). The primary aim
of the current study is to test the effect of a Prodromal Detection and Treatment program at the health care
systems level. The study will investigate: 1) If the combination of information campaigns and detection teams
modelled will help in identifying individuals (age 13–65, fulfilling study inclusion criteria) at high risk of developing
psychosis early, and 2) If a graded, multi-modal treatment program will reduce rates of conversion compared to the
rates seen in follow-along assessments.
Discussion: Positive results could potentially revolutionize therapy by treating risk earlier rather than disorder later
and could open a new era of early detection and intervention in psychosis. Negative results will suggest that the
potential for psychosis is determined early in life and that research should focus more on genetically linked
neurodevelopmental processes.
If we can identify people about to become psychotic with high accuracy, we can track them to understand more
about how psychosis unfolds. Appropriate intervention at this stage could also prevent or delay the onset of
psychosis and/or subsequent deterioration, i.e., social and instrumental disability, suicide, aggressive behavior,
affective- and cognitive deficits.
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