精神分裂症前驱期，即个体开始出现精神分裂症症状但尚保有部分自知力的阶段，被认为是干预的关键时期。研究指出，尽管精神分裂症无法根治，但积极治疗前驱期可能阻止其发展为完全的精神分裂症。这一观点类似于早期发现并治疗癌症或中风，强调早期诊断和治疗的重要性。然而，关于未经治疗的精神病持续时间的统计模型和早期干预的效果，研究仍存在争议和困难。

🧠 精神分裂症前驱期是个体开始出现精神分裂症症状但尚保有部分自知力的阶段，这一时期被认为是进行干预的关键时期。该阶段可能持续数月到数年不等，期间个体的行为可能会出现轻微的异常。

💡 研究表明，积极治疗精神分裂症前驱期有可能阻止其进展为完全的精神分裂症。这种治疗方法被比作早期发现和治疗癌症或中风，强调在疾病造成不可逆损伤前进行干预的重要性。

🔍 然而，关于未经治疗的精神病持续时间（DUP）与不良预后的相关性研究存在争议。一些观察性研究发现DUP与不良预后有一定关联，但也存在许多潜在的混淆因素，如社会经济地位、教育水平等。

🎛 随机对照试验在早期干预精神病方面的结果并不理想，很少显示出明显的好处。实施早期干预的随机对照试验难度较大，特别是在需要伦理委员会批准不进行早期干预的对照组研究时。

🤔 总体而言，关于精神分裂症前驱期的干预研究仍存在不确定性，目前尚无法给出明确的结论。

A prodrome is an early stage of a condition that might have different symptoms than the full-blown version. In psychiatry, the prodrome of schizophrenia is the few-months-to-few-years period when a person is just starting to develop schizophrenia and is acting a little bit strange while still having some insight into their condition.

There’s a big push to treat schizophrenia prodrome as a critical period for intervention. Multiple studies have suggested that even though schizophrenia itself is a permanent condition which can be controlled but never cured, treating the prodrome aggressively enough can prevent full schizophrenia from ever developing at all. Advocates of this view compare it to detecting early-stage cancers, or getting prompt treatment for a developing stroke, or any of the million other examples from medicine of how you can get much better results by catching a disease very early before it has time to do damage.

These models conceptualize psychosis as “toxic” – not just unpleasant in and of itself, but damaging the brain while it’s happening. They focus on a statistic called Duration of Untreated Psychosis. The longer the DUP, the more chance psychosis has had to damage the patient before the fire gets put out and further damage is prevented. Under this model it’s vitally important to put people who seem to be getting a little bit schizophrenic on medications as soon as possible.

There has been a lot of work on this theory, but not a lot of light has been shed. Observational studies testing whether duration of untreated psychosis correlates with poor outcome mostly find it does a little bit, but there’s a lot of potential confounding – maybe lower-class uneducated people take longer to see a psychiatrist, or maybe people who are especially psychotic are especially bad at recognizing they are psychotic. The relevant studies try their hardest to control for these factors, but remember that this is harder than you think. The randomized controlled trials of what happens if you intervene earlier in psychosis tend to do very badly and rarely show any benefit, but randomly intervening earlier in psychosis is hard, especially if you also need an ethics board’s permission to keep a control group of other people who you are not going to intervene early on. Overall I could go either way on this.