Journal article

Detection and treatment of at-risk mental state for developing a first psychosis: making up the balance

Dorien H Nieman, Patrick D McGorry

The Lancet Psychiatry | ELSEVIER SCI LTD | Published : 2015


The at-risk mental state (ARMS) has been substantially researched and used as the basis for new clinical settings and strategies over the past two decades. However, it has also caused controversy and intense debate. In this Review, we assess available evidence and propose future directions. Accumulating research suggests that a blend of clinical staging and profiling, which naturally incorporates ARMS, might be a better guide for treatment of patients in different stages of psychiatric illness than the categorical DSM and ICD systems. Furthermore, clinical staging, with its emphasis on balancing risks and benefits, could help to prevent premature treatment or overtreatment with psychotropic ..

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Funding Acknowledgements

DHN declares no competing interests. PDM is the executive director of Orygen Youth Health and has received research grant funding from the Colonial Foundation, the National Health and Medical Research Council of Australia, the Stanley Foundation, Janssen-Cilag, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, and Pfizer. He has received honoraria and consultancy fees from Janssen-Cilag, Eli Lilly, Pfizer, Lundbeck, Roche, and AstraZeneca. He led the design and implementation, and is director of the board, of headspace.