In the last decades psychiatry has taken an important and overdue step which other medical disciplines had taken much earlier, i.e. recognizing the chances of early detection and intervention–first in the field of emerging psychosis, in the meantime also in other fields.

To review new developments in the field of early detection of psychosis and to critically discuss the obstacles still depriving many of our patients of an immediate benefit.

Review and discussion.

New developments are very promising. Identification of individuals at risk and prediction of transition to psychosis is possible with an excellent accuracy, comparable to other preventive approaches in medicine. And there is growing evidence how this accuracy can even be more improved by using not only clinical assessments but also additional domains such as neurocognition, neurophysiology, or MRI, as well as new methods for analyses such as pattern recognition. Staged intervention according to the degree of risk seems feasible.However, there are still many obstacles to a broad implementation of this new know-how into clinical practice such as lack of communication, political will and finances, or fears, stigma and prejudices.

For the benefit of those concerned - patients and their relatives - a great effort to work together is required from all of us: clinicians, researchers from psychiatry and many other fields, industry, politicians, and last, but not least, patients and their relatives.

The author has not supplied his declaration of competing interest.