Skip to main content Accessibility help
×
×
Home

Contents:

Information:

  • Access
  • Cited by 1
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Smith, Kendra L. 2017. Self-Care Practices and the Professional Self. Journal of Social Work in Disability & Rehabilitation, Vol. 16, Issue. 3-4, p. 186.

    ×

Actions:

      • Send article to Kindle

        To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

        Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

        Find out more about the Kindle Personal Document Service.

        Prevention
        Available formats
        ×

        Send article to Dropbox

        To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

        Prevention
        Available formats
        ×

        Send article to Google Drive

        To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

        Prevention
        Available formats
        ×
Export citation

It is hard to argue against Desiderius Erasmus’s (1466–1536) simple maxim: prevention is better than cure. Indeed, in more recent times prevention has come to be used as an organising principle to create a framework that encompasses almost all medical activity (Bertolote 2009). Primary prevention aims to protect against the occurrence of disease; secondary prevention, to detect and treat early, thus ameliorating the consequences of disease; tertiary prevention, to minimise disabilities. Also described are ‘primordial prevention’ – preventing social and environmental conditions that predispose to disease – and ‘quaternary prevention’ – avoiding the consequences of excessive intervention of the health system (Starfield 2008).

This issue of Advances focuses on secondary prevention in psychosis, with two articles and an editorial from Melbourne, Australia, ‘the cradle of early intervention’ (Castle, pp. 398–400; Murphy & Brewer, pp. 401–407, 408–416). Do good intentions translate to effective treatments and to better and more efficient ways to organise services? Primary prevention in schizophrenia is tricky, as the prodrome is ‘a classic area of uncertainty’ and the majority of those at ‘ultra high risk’ do not develop a major psychotic disorder (Barnes 2011). Does intensive treatment during the so-called critical period lead to better outcomes, not just at the time but in the much longer term? Is reducing the duration of untreated psychosis (DUP) both a realistic goal and likely to alter the disease trajectory? Or is long DUP related to insidious onset and merely a marker of poor prognosis? Are youth-specific services an advantage? And how is transition from specialist to generic services best managed without disrupting continuity of care?

ADHD in adults

Transitions are a fraught issue in attention-deficit hyperactivity disorder (ADHD) too. Fifteen per cent of children diagnosed with ADHD will still meet diagnostic criteria at 25 years of age. Many more will have continuing subsyndromal symptoms (Crimlisk pp. 461–469). At a crucial developmental stage, young people may have to move from one service to another (Singh 2009). Adult mental health teams may be less familiar with the disorder. They may feel ‘scepticism and anxiety’ about the diagnosis and treatment in the same way that child and adolescent mental health services did 30 years ago. My Editor’s pick this month describes the core symptoms of the disorder and how they may manifest differently in adults (Crimlisk, pp. 461–469). In describing how to manage a good transition, the author discusses how services are best integrated and signposts a number of helpful resources for clinicians working in adult mental health teams.

References

Barnes, TRE, Schizophrenia Consensus Group of the British Association of Psychopharmacology (2011) Evidence-based guidelines for the pharmacological treatment of schizophrenia. Journal of Psychopharmacology 25: 567620.
Bertolote, JM (2009) Primary prevention of mental disorders. In New Oxford Textbook of Psychiatry (2nd edn) (eds Gelder, MG, Andreasen, NC, López-Ibor, JJ Jr et al): 1446–51. Oxford University Press.
Singh, SP (2009) Transition of care from child to adult mental health services: the great divide. Current Opinion in Psychiatry 22: 386–90.
Starfield, B, Hyde, J, Gérvas, J et al (2008) The concept of prevention: a good idea gone astray? Journal of Epidemiology & Community Health 62: 580–3.