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January 2008

Back to the Future: Predicting and Reshaping the Course of Psychotic Disorder

Arch Gen Psychiatry. 2008;65(1):25-27. doi:10.1001/archgenpsychiatry.2007.9

For more than a century, pessimism, stigma, and neglect have confined therapeutic efforts in schizophrenia to delayed and inconsistent palliative care. The strategy of early diagnosis, well established in serious physical illnesses, was ignored. However, during the past 15 years, a systematic international collaboration of clinicians and researchers has sought to apply the principles and practice of early diagnosis and staged treatment to the field of schizophrenia and related psychoses.1,2 In general medicine, a premium is placed on detection of the earliest clinical stages of disease: the rapid assessment of a breast lump, the urgent evaluation of new chest pain. These are presentations that may be benign but could be serious or catastrophic if misdiagnosed or inadequately treated.

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