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early-detection-of-psychosis (FEPSY)-study -design and preliminary results.Objective: Early detection and therapy of schizophrenic psychoses have become broadly accepted aims in psychiatry, recently even in very early stages of the disorder when clear diagnostic criteria are not yet fulfilled. However, reliable and widely applicable methods do not yet exist. This study aims at contributing to the improvement of the early assessment of psychosis. Method: Individuals potentially at risk are identified by a newly developed stepwise screening procedure. Identified subjects are then examined extensively and followed-up for at least 5 years to detect actual transition to psychosis. Results: Of 50 subjects who have been followed up for 1-5 years by now, 16 have progressed to frank psychosis, 12 of them during the first 12 months of follow-up. Conclusion: At this stage, our approach seems to be promising for the early detection of psychosis. Further results from this ongoing study will hopefully permit us to optimize the assessment procedure.A. Significant outcomes • Early detection of psychosis and of at risk mental states is possible in a stepwise enrichment strategy using a screening procedure. • This approach is feasible for specialised early detection centres with well trained psychiatrists and the capacity to perform broad information and awareness campaigns. • In the usual clinical setting a major aim of early detection remains the early diagnosis of frank psychosis which is obviously still underdiagnosed and the differential diagnosis of these disorders. Limitations• At this stage of the ongoing study, only preliminary data are available.• Sample size is still small, and follow-up is ongoing.• Definite conclusions and recommendations can only be made after completion of the study.

Some of the structural brain abnormalities in individuals with an at-risk mental state may be related to an increased vulnerability to psychosis, while others are associated with the development of a psychotic illness.