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Early detection can shorten duration of untreated psychosis and help more patients when they are less severely ill. Given the devastation of psychosis, this is a significant treatment advance.

This article describes how four seasoned clinicians and group analysts working in public mental health services, experience their participation in a randomized trial of short-term versus long-term analytic group psychotherapy (20 or 80 sessions). The design makes it possible to integrate the research with regular clinical practice, and participation gives the institutions the opportunity to fulfil obligations of doing research, that are imposed on the Community Mental Health Centres. The experiences are mainly described from the clinicians' position, but some comments from the research director are included. The collaboration across approximately five years is found to be interesting and rewarding. Based on the assumption that further steps are made to strengthen and develop the qualitative aspects of such projects, the clinicians recommend such collaboration as a feasible and useful way to build and maintain a bridge across the gap that too often seems to separate researchers and clinicians. This is assumed to be profitable for everyone involved, not least the patients.

A cross-sectional point prevalence study of the DSM-III-R prodromal symptoms in non-psychotic (n = 501) consecutive outpatients from a catchment area with 260000 inhabitants is presented. The relationship between the three most psychosis-specific prodromal symptoms and the development of psychosis during the following 6 months was also explored. The prevalence of any prodromal symptom was 25%, the most prevalent being impairment of role functioning (14%), isolation and withdrawal (11%) and lack of initiative (8%). The most prevalent symptom in affective disorders was lack of initiative (14%); in personality disorders, it was impairment of role functioning (21%). The prevalences of the most psychosis-specific symptoms "peculiar behaviour", "magical thinking" and "unusual perceptual experiences" was 1-2%. At re-evaluation 6 months later, three of 20 patients (15%) with one or more such symptoms had become psychotic, two with schizoaffective disorder, one with affective psychosis. It was concluded that DSM-III prodromal symptoms are common among non-psychotic outpatients, but most such symptoms are non-specific for psychosis. Persistent peculiar behaviour, magical thinking and unusual perceptual experiences have a very low prevalence but may indicate an increased risk for psychosis. Such patients should be followed with that risk in mind.

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