Early Intervention in Psychosis and Bipolar Disorder in Children and Adolescents – Reflections on Lambert, Niehaus and Correll

The early detection and intervention in psychoses and bipolar disorders have made good progress within the past years. Lambert et al. [1] provide a comprehensive review on the similarities and differences of the early detection and intervention of these disorders with a focus on pharmacological interventions in children and adolescents.

The authors face and name the fundamental problem that many studies in fact include adolescents yet, mostly, only a few patients age 16–18 years and, only in a few studies, patients below the age of 16 years. In this context, the reader must carefully consider the actual age range and the number of minors in each study, especially since most authors inaccurately generalize their findings to “youth”, “adolescents”, or “youngsters” in their conclusions. The same speech confusion exists concerning the definition of clinical high-risk (CHR) criteria [2] [3]. Therefore, it is commendable that Lambert et al. [1] started their review with a precise definition of CHR criteria. The authors of this comment avoid the word “prodromal” in the context of CHR research in order to emphasize the fact that, at the time CHR symptoms occur, the rate of conversion to the full-blown disorder is only about 30%, while “prodromal” should only be used when the full-blown disorder already occurred to describe the CHR state in retrospect [4].

• References

• 1 Lambert M, Niehaus V, Correll CU. Pharmacotherapy in children and adolescent at clinical-high risk for psychosis and bipolar disorder. Pharmacopsychiatry 2016. 49: 229-244
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