Prodromal interventions for schizophrenia vulnerability: the risks of being “at risk”
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Given the morbidity and difficulty of treating psychotic disorders, including schizophrenia, there has been a move toward identifying and treating adolescents and young adults who appear to be clinically at risk or "prodromal" to psychosis. The field now has greater specificity in identification, with rates of 40-50% conversion to frank psychosis within 1-2 years. There is further evidence that medications and other treatments may have some efficacy for "prodromal" patients, though with variable side effects. However, controversy remains about some of the inherent risks in prodromal research, such as medication exposure and stigma among false-positives. In this paper, we add to this discussion through an analysis of ethics in prodromal research from the more established field of predictive genetic testing. Issues are raised about the effects of information on patients, families, and institutions, as well as future insurability, the limits of confidentiality (as it relies on discretion of patients and families), the autonomy of minors with psychiatric symptoms, and even the risks for the true-positive patient.
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Without suitable public education, risk or vulnerability conditions may be mistaken for full-blown mental disorders.
“In fact, without appropriate public education, risk/vulnerability condi tions may be confounded with the full-blown mental disorders 143,146 .”
From Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs (2024) · cites this paper as [146]
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Self-citationEthical and Epidemiological Dimensions of Labeling Psychosis Risk
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Ethical Considerations in Psychiatric Genetics
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Are current labeling terms suitable for people who are at risk of psychosis?
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Chances and risks of predicting psychosis
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Public Mental Health and Prevention
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- Authors
- Corcoran, C., Malaspina, D., & Hercher, L.
- Affiliations
- New York State Psychiatric Institute (US)
- Corresponding author
- Corcoran, Cheryl
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2005-03
- Volume
- 73
- Issue
- 2-3
- Pages
- 173-184
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC2987621
- OpenAlex
- W2139095930
- Cited by
- 183
- References
- 44
- Citations by year
- 2025: 6 · 2024: 8 · 2023: 2 · 2022: 7 · 2021: 9 · 2020: 6 · 2019: 10 · 2018: 2 · 2017: 4 · 2016: 6 · 2015: 8 · 2014: 6 · 2013: 12 · 2012: 9
- FWCI
- 5.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- G. Harold and Leila Y. Mathers Foundation
- National Institute of Mental Health (MH01699 K24, R01 MH 59114, K24MH001699, R01MH059114)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- prodromal psychosis, schizophrenia
- MeSH terms
- Confidentiality, Humans, Risk Factors, Schizophrenia, Stereotyping, United States, Health Insurance Portability and Accountability Act, Personal Autonomy
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