Guidelines for the prevention of psychosis from the World Federation of Societies of Biological Psychiatry (WFSBP) and EPI Canada
Year: 2026
Type: article
Abstract: OBJECTIVE: To prepare evidence-based guidelines on psychosis prevention. METHODS: We reviewed evidence on risk factors for/age at onset of psychosis, tools to assess clinical high-risk of psychosis (CHR-P), transition rates, risk calculation/ethical considerations around risk communication, CHR-P biological/clinical correlates, efficacy/cost-effectiveness of interventions/psychosis prevention services. The World Federation of Societies of Biological Psychiatry framework was used to grade evidence regarding interventions/services, elaborating guidelines with evidence-/consensus-based clinical recommendations to prevent psychosis in CHR-P subjects. RESULTS: At the service organisation level, (i) psychosis indicated prevention services might be implemented in close collaboration with early intervention services for psychosis to minimise duration of untreated illness, (ii) intake age criteria should be between 14 to 35, (iii) services should allow access to persons with cannabis use disorder. At the assessment and risk communication level, in clinical settings: (iv) staff in mental health services should be trained in administering/rating CHR-P assessment tools, (v) administer them, (vi) be trained in using/interpreting risk calculators, and (vii) in communicating risk, (viii) only use validated risk calculators, keeping a human-to-human interaction. Also, (ix) prevention services should assess comorbid mental disorders. At the intervention level: (x) staff should offer treatment for abstinence from cannabis, (xi) offer evidence-based treatment for comorbid mental disorders, and (xii) offer treatment for CHR-P based on patient preference, following the 'first do no harm' principle. CONCLUSIONS: Prevention services should be implemented, including interventions for cannabis use, reducing the duration of untreated psychosis, and treating comorbid mental disorders.
Authors: Marco Solmi, Christoph U. Correll, Tommaso Boldrini, Jean M. Addington, Edgar Barbezat, Stella Bassetto, Andreas Bechdolf, Dan Devoe, Joseph Firth, Paolo Fusar-Poli, Ary Gadelha, Renan Göksal, Matcheri Keshavan, Eoin Killackey, Nikolaos Koutsouleris, Gabriele Lo Buglio, Mirko Manchia, Patrick McGorry, Jai Shah, Helen J. Stain, Philip G. Tibbo, Thomas Hastings, Howard C. Margolese, Nicola Otter, Eduard Vieta, Liang-Jen Wang, Scott W. Woods, Lakshmi N. Yatham, Alison R. Yung, Muhammad Omair Husain, Peter Falkai, Michael Berk, Andre F. Carvalho
Institutions: University of Ottawa, Ottawa Hospital, Ottawa Hospital Research Institute, Charité - Universitätsmedizin Berlin, Northwell Health, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Zucker Hillside Hospital, Pegaso University, University of Calgary, Hotchkiss Brain Institute, Universidade de São Paulo, Universidade Presbiteriana Mackenzie, Humboldt-Universität zu Berlin, Klinikum im Friedrichshain, Deutsches Zentrum für Psychische Gesundheit, Mount Royal University, Manchester Academic Health Science Centre, University of Manchester, Western Sydney University, King's College London, South London and Maudsley NHS Foundation Trust, University of Pavia, Universidade Federal de São Paulo, University of Padua, Beth Israel Deaconess Medical Center, Harvard University, Massachusetts Mental Health Center, The University of Melbourne, Orygen, Max Planck Institute of Psychiatry, Ludwig-Maximilians-Universität München, Dalhousie University, University of Cagliari, Azienda Ospedaliero-Universitaria Cagliari, Douglas Mental Health University Institute, McGill University, Nova Scotia Health Authority, University of Toronto, McMaster University, McGill University Health Centre, Centro de Investigación Biomédica en Red de Salud Mental, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Kaohsiung Chang Gung Memorial Hospital, Yale University, University of British Columbia, Barwon Health, Deakin University, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, University Hospital
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7162512753