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Page Background European Psychiatry 41S (2017) S6–S7

Available online at


25th European Congress of Psychiatry

State of the art

State of the art: Working together for early

detection of psychosis


Working together for early detection

of psychosis

A. Riecher-Rössler

University of Basel psychiatric hospital, CH-4051, Basel, Switzerland


In the last decades psychiatry has taken an impor-

tant 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 mean-

time 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 pos-

sible 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 newmethods 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


Disclosure of interest

The author has not supplied his declaration

of competing interest.

State of the art: psychotherapies vs.

pharmacotherapies vs. combination therapies in

depressive and anxiety disorders


Psychotherapies vs.

pharmacotherapies vs. combination

therapies in depressive and anxiety


P. Cuijpers

Faculty of Behavioural and Movement Sciences, Vrije Universiteit,

Amsterdam, The Netherlands

Both psychological and pharmacological therapies have been found

to be effective in the treatment of adult depression and anxi-

ety disorders. Psychological treatments include cognitive behavior

therapy, interpersonal therapy, behavioral activation, exposure

therapies, and several other types of therapy. Pharmacological

treatments include SSRIs, SNRIs TCAs, MAIOs and several other

types. In this presentation the results of meta-analyses of trials

directly comparing the effects of psychological and pharmalogical

treatments will be presented, as well asmeta-analyses of combined

treatments versus either psychotherapy alone or pharmacotherapy

alone. Results show that psychological and pharmacological treat-

ments are probably about equally effective at the short term, and

combined treatment is more effective than either psychotherapy

or pharmacotherapy alone. In the presentation several other issues

related to this group of trials will be discussed, like the influence

of conflicts of interest and the (lack of) blinding in psychotherapy


Disclosure of interest

The author has not supplied his declaration

of competing interest.