**15. Disadvantages of "prodromal" identification**

Identification by different methods of people at risk of psychosis in the general population has allowed an increase in accuracy from a rate of 1% to a rate of approximately 30% [1]. However, the increase in accuracy has raised some criticism. One is that the screening would not be effective in the general population because of the lower base rate of psychotic illness in that population [38], so screening for UHR criteria would not be supported at this stage [19]. The second criticism is that there is a high false positive rate in all of these studies, the majority of participants not developing psychotic disorder. Consequently, some persons will be "diagnosed" and treated as if they were at "high risk" of psychosis, when this may not be true. This false identification may have negative consequences on those individuals: they may become anxious or depressed about the possibility of developing schizophrenia or receiving treatment, stigmatized by others or themselves or both [39]. These people may be exposed to drug or other therapies, with potential adverse effects without gaining any benefit [39, 40–43]. This controversy on the risk benefit balance of early intervention strategies must be addressed by future studies.
