Schizophrenia Prediction and Prevention: What Do We Know?. Puru Thapa, M.D., M.P.H. Associate Professor Department of Psychiatry, UAMS Staff Psychiatrist, Arkansas State Hospital 03/15/2014. Objectives. Review definition, epidemiology and etiology of schizophrenia
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Schizophrenia Prediction and Prevention: What Do We Know?
Puru Thapa, M.D., M.P.H.
Department of Psychiatry, UAMS
Staff Psychiatrist, Arkansas State Hospital
3: Disorganized speech
4: Disorganized or catatonic behavior
5: Negative symptoms
Wu EQ and colleagues, J Clin Psych 2005;66:1122-1129
True Positive (TP)
False Positive (FP)
False Negative (FN)
True Negative (TN)
PPV = TP/(TP+FP) or a/(a+b) = 80/(80+100) = 44%
NPV = TN/(FN+TN) or d/(c+d) = 800/(800+20) = 98%
Prevention of disease by altering susceptibility or reducing exposure for susceptible individuals
e.g., immunization, exercise
Early detection and treatment of disease
e.g., breast cancer screening, screening for disease (occult blood in stool for colon cancer)
Limitation of disability and rehabilitation
Alleviation of disability resulting from disease and attempts to restore function (Post-stroke rehabilitation)
Prevention – can be population-based or high risk group approach
Prodromal Phase Focus of Intervention
Note: 43 of 59 (73%) did not progress to psychosis at 12 months
At one year, 16.1% of olanzapine and 37.9% of placebo converted to psychosis (p=.08). Olanzapine group had more improvement in symptoms.
At two years, most were lost to follow-up; but of remaining no difference