COMMENTARY

The Year in Psychosis and Bipolar Disorder: The Most Important Studies of 2010

The Most Important Studies of 2010

Christoph U. Correll, MD; Marta Hauser, MA

Disclosures

January 07, 2011

In This Article

Prevention of Mood and Psychotic Disorders

Prevention is the Holy Grail of medicine. In the past decade, prevention of mental illnesses has become a topic of vast interest and relevance in the field of psychiatry research. In recent years, several pharmacologic and nonpharmacologic intervention studies have been conducted that focused on the putative "prodromal" phase of psychosis, defined by the onset of attenuated positive symptoms in the past 12 months; brief (less than 1 week duration) self-limiting full psychotic symptoms; a drop in functionality equivalent to a drop in the Global Assessment of Functioning (GAF) scale by ≥30% in the context of familial high-risk status (ie, a first-degree family member with schizophrenia or schizotypal personality); or the presence of self-perceived cognitive or perceptual abnormalities.[1] Considering the potentially serious side effects of antipsychotic medications, along with considerable rates of false-positive nonconverters, and, more recently, reports of decreasing conversion rates to psychosis, staging models that titrate the potential for adverse effects to the severity of symptoms, and the likelihood of conversion in help-seeking populations are under investigation.[2] In this context, 2010 studies by Jacka and colleagues[3] and Amminger and colleagues[4] refer to diet and dietary products as, respectively, primary prevention (ie, no illness signs yet) and "indicated prevention," given that the intervention is applied to individuals exhibiting initial but subthreshold signs of psychosis. Jacka and colleagues' results, although preliminary, are intriguing as they suggest the potential for broad and basic prevention of high prevalence mental disorders like depression and anxiety, with relevance for bipolar disorder and psychotic disorders in which both depression and anxiety are common.

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