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New research clinic seeking to identify schizophrenia earlier

Yale Medicine Magazine, 1999 - Winter


While traditional treatment of schizophrenia, or psychosis, seeks to reduce symptoms after they have affected people’s lives, the psychiatry department’s new PRIME Research Clinic is launching the first study in the country to explore the prevention, delay or reduction of serious symptoms. Through early identification and treatment, the clinic hopes to address the disease before it becomes debilitating.

The PRIME clinic, which stands for Prevention through Risk Identification, Management and Education, will study individuals who, while in the prime of their lives, show signs of being at risk for developing a debilitating mental illness. It includes people from ages 14 to 45 who are concerned with a recent change in their thoughts or feelings.

Possible signs that someone may be at risk for mental illness include a sudden decline in work or school performance, social withdrawal, trouble concentrating or thinking clearly, feelings of suspicion or worry about the intentions of other people without apparent justification, and bizarre changes in the way things look or sound. These experiences may be accompanied by mood shifts such as depression, anxiety or angry outbursts, explains Thomas H. McGlashan, M.D., professor of psychiatry, executive director of the Yale Psychiatric Institute and leader of the study.

Dr. McGlashan and the PRIME clinic plan to provide those entering the study with preventive counseling as well as participation in a medication trial. The experimental program will offer treatment for one year followed by one year of monitoring.

Preliminary results from research conducted in Australia indicate that early intervention may prevent symptoms from developing or may significantly reduce symptoms of psychosis. “Most people diagnosed with serious mental disorders encounter sometimes irreversible reduction in quality of life, including failure at work or school, loss of sense of self, social estrangement, or distractions from persistent voices and fear of persecution,” Dr. McGlashan says. “Because of its early onset—typically in the late teens and early twenties—schizophrenia robs society of its victims’ intellectual and physical productivity.”

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