**5. Treatment**

In the prodromal and in the onset phase of psychosis, neurobiological changes can be identified. During the process of transition to psychosis, magnetic resonance imaging (MRI) highlights significant bilateral reduction in gray matter volume in the cingulate region as well as in the left parahippocampal gyrus, left fusiform gyrus, left orbitofrontal cortex, and one region of the left cerebellar cortex [1]. It is important to notify that these brain changes were not present in the UHR group that did not develop psychosis.

The differentiation between normal and abnormal has important implications for defining the prodromal phase of schizophrenia and the therapeutic interventions at this early stage. Atypical antipsychotics has improved the treatment and the outcome of schizophrenia and psychosis due to their low risk for adverse effects like extrapyramidal effects, tardive dyskinesia, sedation, weight gain, metabolic syndrome, amenorrhea, galactorrhea, sexual dysfunctions, etc.

Psychosocial interventions give optimism regarding the prognosis of disease by improving family and social difficulties, stigma avoidance, victimization, isolation, and poverty [13].

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*Schizophrenia: Early Recognition and Prevention DOI: http://dx.doi.org/10.5772/intechopen.88537*

to psychosis.

psychosis:

If the prodrome can be recognized prospectively and treatment can be provided at this stage, then disability could be minimized, some recovery may be possible before symptoms and poor functioning become obvious, and the possibility of

• To slow or possibly to stop further deterioration and even further progression

• To evaluate and prevent secondary morbidity in order to decrease morbidity

• To reduce the poor functional outcome characterizing many vulnerable

• To create research opportunities to develop new therapeutic strategies.

Early intervention has to take place in the three important phases of early

a.In the phase of risk when the symptoms are subtle and can be confused with

b.In the period of frank psychosis in which if the symptoms remain untreated,

c.In the critical period after the onset of the first episode of psychosis, a period which can last up to 5 years after the onset, the length of time that treatment

The latest attempts redefining the concept of psychosis have focused particularly

on the first episode of psychosis and on prodromal stage of schizophrenia.

**7. A history of prodrome: benefits of diagnosis of the prodrome**

Over 100 years ago, Emil Kraepelin (1896), cited by Patrick McGorry at the beginning of the chapter "A stitch in time" [14], wrote "it is of the greatest medical

• Clinical heterogeneity of patients diagnosed with first psychotic episode.

Arguments for these new concepts can be synthesized as:

• The heterogenous outcome of these patients.

• The instability of the diagnosis over time.

• Avoidance of negative prognostic.

preventing is feasible and realistic. The early intervention aims:

individuals, whether or not psychosis actually develops.

particularities and difficulties specific to adolescence.

there is a risk of temporal or permanent disability.

should be comprehensive and specific.

**6. Redefining psychosis**

• Stigma avoidance.

and mortality in the first episode of psychosis.

• To develop secondary prevention strategies.
