CLINICAL HANDBOOK OF SCHIZOPHRENIA

37. Treatment of the Schizophrenia Prodrome 389• Although there is evidence for the effectiveness of a combination of low-dose antipsychoticmedication and cognitively oriented psychotherapy in delaying rate of transition to psychosiscompared to supportive psychotherapy alone, the active component in therapy stillneeds to be distilled.• In recognition of the need for further evaluation of the appropriateness and efficacy ofantipsychotics in the UHR population, these medications should not be considered as a firsttreatment option for this group at present.• It is important to continue research into the most potent vulnerability markers for transitionfrom ARMS to full psychosis, because this will assist in the accurate identification of trulyprodromal individuals and guide the refinement of treatment interventions.REFERENCES AND RECOMMENDED READINGSAddington, J., Francey, S. M., & Morrison, A. P. (Eds.). (2006). Working with people at high risk ofdeveloping psychosis. Chichester, UK: Wiley.Corcoran, C., Walker, E., Huot, R., Mittal, V., Tessner, K., Kestler, L., et al. (2003). The stress cascadeand schizophrenia: Etiology and onset. Schizophrenia Bulletin, 29(4), 671–692.McGorry, P. D., Yung, A. R., & Phillips, L. J. (2003). The “close-in” or ultra high-risk model: A safeand effective strategy for research and clinical intervention in prepsychotic mental disorder.Schizophrenia Bulletin, 29(4), 771–790.McGorry, P. D., Yung, A. R., Phillips, L. J., Yuen, H. P., Francey, S., Cosgrave, E. M., et al. (2002). Arandomized controlled trial of interventions designed to reduce the risk of progression to first episodepsychosis in a clinical sample with subthreshold symptoms. Archives of General Psychiatry,59, 921–928.Morrison, A. P., Bentall, R. P., French, P., Walford, L., Kilcommons, A., Knight, A., et al. (2002). Randomizedcontrolled trial of early detection and cognitive therapy for preventing transition to psychosisin high-risk individuals: Study design and interim analysis of transition rate and psychologicalrisk factors. British Journal of Psychiatry Supplement, 43, s78–s84.Morrison, A. P., French, P., Walford, L., Lewis, S. W., Kilcommons, A., Green, J., et al. (2004). Cognitivetherapy for the prevention of psychosis in people at ultra-high risk: Randomized controlledtrial. British Journal of Psychiatry, 185(4), 291–297.Parnas, J. (2003). Self and schizophrenia: A phenomenological perspective. In T. K. A. David (Ed.),The self in neuroscience and psychiatry (pp. 127–141). Cambridge, UK: Cambridge UniversityPress.Phillips, L. J., & Francey, S. M. (2004). Changing PACE: Psychological interventions in theprepsychotic phase. In J. F. M. Gleeson & P. D. McGorry (Eds.), Psychological interventions inearly psychosis: A treatment handbook (pp. 23–39). Chichester, UK: Wiley.Yung, A. R., Phillips, L. J., & McGorry, P. D. (2004a). Treating schizophrenia in the prodromal phase.London: Taylor & Francis.Yung, A. R., Phillips, L. J., Yuen, H. P., & McGorry, P. D. (2004b). Risk factors for psychosis in anultra high-risk group: Psychopathology and clinical features. Schizophrenia Research, 67, 131–142.