The Critical Period for Early Intervention

Abstract Therapeutic intervention in psychotic disorders has been evolving steadily in recent years with notable changes in the content of treatment (e.g., atypical neuroleptics and the cognitive/psychosocial interventions) and the locus of care. While the therapeutic focus continues to emphasize acute and treatment symptoms, and longer-term interventions, for example assertive community treatment, the primary and secondary prevention of psychosis has received little attention since Cameron's (1938) pioneering work. It is now believed that the variables influencing the early phase of psychosis are sufficiently well developed to begin exploring their therapeutic implications. More speculatively, the early phase of psychosis is believed to be formative in biological, psychological, and social terms, thus affording major opportunities for secondary prevention. Three key elements of an early intervention strategy are proposed: early detection of “at-risk” mental states; early treatment of first psychotic episode; and interventions targeted during the early phase of psychosis (the “critical period”).