“Three decades ago, the schizophrenia field finally began to challenge the intrinsic pessimism that had inhibited preventive approaches for a century. Early detection and specialized early treatment models for first-episode psychosis have since become the global standard of care, producing better outcomes that “bend the curve” of the early course of illness1 and have opened the door to the prevention or delay of the first episode of psychosis. The development of operational criteria (the “ultra” or “clinical” high risk [CHR] criteria) for identifying what we originally termed the at-risk mental state meant that an even earlier stage of illness could be identified prospectively and studied for its heuristic and therapeutic potential. ….”

McGorry PD and Nelson B: Clinical High Risk for Psychosis—Not Seeing the Trees for the Wood. JAMA Psychiatry 77(7):559-560 (2020).



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