• M B de Koning, O J N Bloemen, T A M J van Amelsvoort, H E Becker, D H Nieman, M van der Gaag, and D H Linszen.
• Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands. m.b.dekoning@amc.uva.nl
• Acta Psychiatr Scand. 2009 Jun 1; 119 (6): 426-42.

ObjectivePrediction of transition to psychosis in the prodromal phase of schizophrenia has raised interest in intervention prior to the onset of frank psychosis. The aim of this review was to examine whether interventions in the prodromal phase have a favourable benefit/risk ratio.MethodA literature search in PubMed, EMBASE and PsycINFO was performed.ResultsThree randomized clinical trials with antipsychotic medication and/or cognitive behavioural therapy as clinical intervention suggested a positive effect at the end of treatment, but no significant differences were found at the end of follow-up periods from 1 to 4 years. Naturalistic studies present a hypothesis about a possible preventive effect of antidepressive medication. The results of eight other studies are more difficult to interpret. Side-effects of antipsychotic medication and non-adherence with medication are essential problems.ConclusionAt the present time, the data concerning the benefits and risks do not justify prodromal intervention as standard clinical practice.

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