Table of Contents
ISRN Psychiatry
Volume 2012 (2012), Article ID 219642, 7 pages
http://dx.doi.org/10.5402/2012/219642
Review Article

Emerging Psychosis and the Family

Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Agaplesion Elisabethenstift Evang. Krankenhaus gGmbH, Landgraf-Georg-Straße 100, 64287 Darmstadt, Germany

Received 16 January 2012; Accepted 6 February 2012

Academic Editors: C. M. Buchalla and A. R. Mawson

Copyright © 2012 Martin Hambrecht. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Schizophrenias hold a special position among psychotic disorders. Schizophrenias often start in early adulthood and bear considerable psychosocial risks and consequences. Several years of nonpsychotic clinical signs and symptoms and growing distress for patient and significant others may pass by before definite diagnosis. Young males in particular often experience their first episode while still living in their primary families. Thus, the whole family system is involved. In worldwide initiatives on early detection and early intervention, near-psychotic prodromal symptoms as well as deficits of thought and perception, observable by the affected person himself, were found to be particularly predictive of psychosis. Various psychological and social barriers as well as ones inherent to the disease impede access to affected persons. Building trust and therapeutic alliance are extremely important for counseling, diagnostics, and therapy. The indication for strategies of intervention differs from the early to the late prodromal stage, depending on proximity to psychosis. For psychotherapy versus pharmacotherapy, the first evidence of effectiveness has been provided. A false-positive referral to treatment and other ethical concerns must be weighed against the risks of delayed treatment.