People who develop schizophrenia often have a prodromal period with changes in their thoughts, mood, and behaviour prior to the start of psychotic symptoms. This overlaps with a more recent concept, known as an ‘at-risk mental state’, which typically refers to people with sub-diagnostic psychotic symptoms presenting to services. People with an at-risk mental state are at much higher risk of developing psychosis than the general population with up to one third going on to develop psychosis.[58]
Research has shown that it may be possible to identify people with an at-risk mental state:[58][59]
They may present with distress and/or a decline in their social functioning in conjunction with transient or attenuated psychotic symptoms
They should be referred to an early intervention in psychosis service for assessment
Treatment with cognitive behavioural therapy or antipsychotic medication can reduce the risk of transition to psychosis