S20-05 The critical period - 17/03/09
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Résumé |
Aim |
Evidence from long-term follow-up studies of schizophrenia and from the ‘new epidemiology’ of psychoses has forced us to rewrite the textbooks and challenge accepted wisdom. In this paper I aim to review the concept of my ‘Critical Period’ in the long-term trajectory of schizophrenia.
Method |
I will review long-term follow-up studies of first episode psychosis.
Results |
Studies suggest that:
a. | the course of the psychoses is very variable; |
b. | much of this variability is laid down during the ‘prodromal’ and first 3 - 5 years following the first episode; |
c. | the ‘disability’ plateaus quickly, much of it occuring before the positive symptoms develop (the ‘symptom-disability gap’) but |
d. | the psychosocial and ecological risk factors that have now been uncovered, suggest a more protean, malleable process in the development of psychosis, as witnessed, for example by the considerable number of ‘at risk’ individuals with low-level, but disabling psychotic symptoms, who escape psychosis (the misnomer of the ‘false positive’). |
Conclusion |
This picture presents a fresh take on my concept of the ‘critical period’ with implications for public health and prevention.
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Vol 24 - N° S1
P. S110 - 2009 Retour au numéro
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- M. Nordentoft, M. Bertelsen, P. Jeppesen, L. Petersen, A. Thorup, P. Le Quack, G. Krarup, P. Jørgensen
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