OBJECTIVE: Two forms of early intervention in @entity716 are currently being proposed--intervention before the onset of illness with at-risk individuals and intervention after the onset of @entity716 . METHOD: The risks and potential benefits associated with these two approaches were examined using published data and Bayes probability theorem. RESULTS: Claims for benefits from early intervention in established @entity716 go back more than two hundred years to the nineteenth-century advocates for asylum construction. Theoretical support for early intervention in @entity716 rests on data suggesting that a longer duration of untreated @entity716 (DUP) is associated with poor outcome. The association of DUP with outcome, however, appears to be inseparable from the confounding influence of the good outcome expected in recent-onset @entity716 . Although some researchers advocate treating @entity1 with premorbid features of @entity716 or other high-risk indicators, adequate screening measures and effective interventions are not yet available. The most promising current screening measure, if applied to the general population, would be accurate only two percent of the time. The accuracy of these measures can be improved by screening only those @entity1 who are referred to a clinic, but this strategy will result in many cases in the population-at-large being overlooked. DISCUSSION: The risks and potential benefits associated with the two early intervention approaches are very different. The provision of optimal treatment early in @entity716 could produce benefits, but @entity1 with brief, good-prognosis @entity716 are likely to receive unnecessary treatment. Screening the general population or @entity1 referred to a clinic will have little public health impact on the incidence of @entity161 . There is likely to be considerable negative impact on those who are inaccurately labeled as being at imminent risk of @entity716 and are treated accordingly.

Early intervention in XXXX : a critique.

@entity1 :: ('9606', 'Species') :: ['patients', 'people'] @entity161 :: ('MESH:D012559', 'Disease') :: ['schizophrenia'] @entity716 :: ('MESH:D011605', 'Disease') :: ['psychotic episodes', 'psychosis']
@entity161 :: (MESH:D012559,Disease) :: ['schizophrenia']
