The low rate of transition to psychosis in both the treatment and control groups in this study – and the recovery from psychosis and affective symptoms among those in both groups, is "clearly an important and optimistic message to convey; both for young help seeking people meeting the criteria for being in an at risk mental state and for clinicians in contact with this population.
"It should encourage a normalizing, non-catastrophic perception on their psychotic experiences, and any treatment should largely be needs driven on the basis of what problems are presented and prioritized by service users; this is something that cognitive therapy is suited to, given its collaborative, problem oriented nature," they said.
Active monitoring also might be of benefit and would be benign, easy to implement, and consistent with guidelines, Dr. Morrison and his coworkers added.
Given the findings of this study, and given the adverse effects associated with antipsychotics, the investigators suggest that antipsychotics not be delivered as a first-line treatment for those meeting the criteria for being in an at-risk mental state.
This study was supported by the UK Medical Research Council and the UK Department of Health. None of the authors had disclosures to report.