@article{88191a97d17446fea2a113f9fd9a8801,
title = "Counterpoint. Early intervention for psychosis risk syndromes: Minimizing risk and maximizing benefit",
abstract = "Background: Malhi et al. in this issue critique the clinical high risk (CHR) syndrome for psychosis. Method: Response to points of critique. Results: We agree that inconsistency in CHR nomenclature should be minimized. We respectfully disagree on other points. In our view: a) individuals with CHR and their families need help, using existing interventions, even though we do not yet fully understand disease mechanisms; b) substantial progress has been made in identification of biomarkers; c) symptoms used to identify CHR are specific to psychotic illnesses; d) CHR diagnosis is not “extremely difficult”; e) the pattern of progression, although heterogenous, is discernible; f) “psychosis-like symptoms” are common but are not used to identify CHR; and g) on the point described as {\textquoteleft}the real risk,{\textquoteright} CHR diagnosis does not frequently cause harmful stigma. Discussion: Malhi et al.'s arguments do not fairly characterize progress in the CHR field nor efforts to minimize stigma. That said, much work remains in areas of consistent nomenclature, mechanisms of disease, dissecting heterogeneity, and biomarkers. With regard to what the authors term the “real risk” of stigma associated with a CHR “label,” however, our view is that avoiding words like “risk” and “psychosis” reinforces the stigma that both they and we mean to oppose. Moreover, patients and their families benefit from being given a term that describes what is happening to them.",
keywords = "Autonomy, Beneficence, Biomarkers, Clinical high risk (CHR), Psychosis, Stigma",
author = "Woods, {Scott W.} and Bearden, {Carrie E.} and Sabb, {Fred W.} and Stone, {William S.} and John Torous and Cornblatt, {Barbara A.} and Perkins, {Diana O.} and Cadenhead, {Kristin S.} and Jean Addington and Powers, {Albert R.} and Mathalon, {Daniel H.} and Calkins, {Monica E.} and Wolf, {Daniel H.} and Corcoran, {Cheryl M.} and Horton, {Leslie E.} and Mittal, {Vijay A.} and Jason Schiffman and Ellman, {Lauren M.} and Strauss, {Gregory P.} and Daniel Mamah and Jimmy Choi and Pearlson, {Godfrey D.} and Shah, {Jai L.} and Paolo Fusar-Poli and Celso Arango and Jesus Perez and Nikolaos Koutsouleris and Jijun Wang and Kwon, {Jun Soo} and Walsh, {Barbara C.} and McGlashan, {Thomas H.} and Hyman, {Steven E.} and Gur, {Raquel E.} and Cannon, {Tyrone D.} and Kane, {John M.} and Alan Anticevic",
note = "Funding Information: Preparation of this article was supported in part by US National Institute of Mental Health grants U01MH082022 , R01MH121095 , R01MH107250 , U01MH081928 , R01MH111448 , K23MH116130 , U01MH081857 , R01MH105084 , U01MH082004 , U01MH081944 , R01MH105243 , U01MH081984 , R01MH105178 , K23MH115252 , U01MH076989 , R01MH113565 , R01MH107558 , R01MH115332 , R01MH113533 , R01MH112545 , R01MH116039 , R01MH120088 , R01MH112612 , R34MH110506 , R01MH112613 , R21MH119438 , R33MH111850 , R01MH119219 , U01MH081902 , R01MH112189 , and R01MH115000 ; and by US Substance Abuse and Mental Health Services Administration grants H79SM081190 , H79SM081092 , H79SM081192 , and H79SM081196 ; and by the Burroughs Wellcome Fund and Fonds de Recherche du Qu{\'e}bec - Sant{\'e} . Funding Information: Preparation of this article was supported in part by US National Institute of Mental Health grants U01MH082022, R01MH121095, R01MH107250, U01MH081928, R01MH111448, K23MH116130, U01MH081857, R01MH105084, U01MH082004, U01MH081944, R01MH105243, U01MH081984, R01MH105178, K23MH115252, U01MH076989, R01MH113565, R01MH107558, R01MH115332, R01MH113533, R01MH112545, R01MH116039, R01MH120088, R01MH112612, R34MH110506, R01MH112613, R21MH119438, R33MH111850, R01MH119219, U01MH081902, R01MH112189, and R01MH115000; and by US Substance Abuse and Mental Health Services Administration grants H79SM081190, H79SM081092, H79SM081192, and H79SM081196; and by the Burroughs Wellcome Fund and Fonds de Recherche du Qu?bec - Sant?. Funding Information: Dr. Woods reports that he has received sponsor-initiated research funding support from Teva, Boehringer-Ingelheim, Amarex, and SyneuRx. He has consulted to Boehringer-Ingelheim, New England Research Institute, and Takeda. He has been granted US patent no. 8492418 B2 for a method of treating prodromal schizophrenia with glycine agonists. Dr. Hyman serves on the board of directors for Voyager Therapeutics, and on scientific advisory boards for Janssen, BlackThorn Therapeutics, F-Prime Capital, and Brave Neuroscience. He is also the Board Chair for the nonprofit Charles A. Dana Foundation and a consultant for Q-State Biosciences, and has received research funding from the Stanley Family Foundation. Other authors report no disclosures. Publisher Copyright: {\textcopyright} 2020 Elsevier B.V.",
year = "2021",
month = jan,
doi = "10.1016/j.schres.2020.04.020",
language = "English",
volume = "227",
pages = "10--17",
journal = "Schizophrenia research",
issn = "0920-9964",
}