Stage 1 · Clinical need
Why people at clinical high risk are a research priority
- Work status
- Background Existing research; not programme activity
- Sources used
- Published research Published guidance
The question
What is known about people who meet criteria for clinical high risk of psychosis (CHR-P), and what care is recommended today?
What is known
- CHR-P is not a diagnosis of psychosis or schizophrenia, and most people in this group do not develop psychosis.
- An updated meta-analysis estimated that about one in four people identified as CHR-P (pooled estimate, 25%) developed psychosis within three years.
- In England, psychological therapy is the recommended first step. NICE advises against antipsychotics to prevent psychosis in this group.
- No preventive intervention has been shown to work better than the others.
What further research would establish
Larger, well-designed trials in this group. For each intervention studied so far, the trials are few and small.

What supports this? 4 sources
Salazar de Pablo et al. — probability of transition to psychosis (updated meta-analysis), JAMA Psychiatry
Evidence library entry Original source: DOI Original source: PubMed
NICE CG155 — psychosis and schizophrenia in children and young people
NICE CG178 — psychosis and schizophrenia in adults
Davies et al. — network meta-analysis of preventive interventions, World Psychiatry
Evidence library entry Original source: DOI Original source: PubMed



