The PACE Clinic: A Potential Breakthrough

Schizophrenia affects 1% of the population worldwide. If schizophrenia is inherited and runs in the family, that risk increases by approximately 10% (Mejia, 2014). Awareness of a genetic risk factor, prior to onset, may be beneficial to the person potentially at risk, especially if caught at an early age. One way clinicians are trying to combat the potential risk of schizophrenia is a method called the Personal Assessment and Crisis Evaluation (PACE) Clinic.

The PACE Clinic is an intervention prior to the potential onset of schizophrenia. According to the Medical Journal of Australia, this method is meant to delay or prevent the onset or severity of the symptoms of schizophrenia (Yung et al, 2007). Symptoms shown preceding the diagnosis of schizophrenia are called the prodromal phase. According to the medical dictionary, prodromal means, “pertaining to early symptoms that may mark the onset of a disease”. Around 35% of patients meeting the prodromal criteria develop a psychotic disorder within a year (Yung et al, 2007).

It is often hard to tell what prodromal symptoms are compared to those of other illnesses. These pre-onset symptoms are not the usual schizophrenia symptoms described in the DSM-5, such as hallucinations, delusions, or disorganized speech (APA, 2013). Distinctive signs in the prodromal phase typically include depressed mood, sleep problems, and anxiety. The issue for these prodromal indicators is that they could possibly be mistaken for psychosis, when in reality they are another mental disorder such as depression or anxiety (Yung & Nelson, 2011).

This type of intervention, according to Alison Yung, uses methods such as cognitively oriented psychotherapy and low-dose antipsychotic medication. The Orygen Youth Health explains the treatment as involving visiting homes, supporting families, involving the patient in group programs and participation, giving neuropsychological and occupational therapy interventions, and referring the patient to other community agencies (Orygen Youth Health). Individuals are monitored regularly under the supervision of doctors (Parker & Lewis, 2006). These are all methods to help delay or prevent the development of psychosis.

One disadvantage to the PACE study is that there may be false positives when it comes to diagnosing the prodromal phase. With these false positives, patients are often given unnecessary treatment because they don’t actually meet the prodromal criteria (Yung et al, 2007).

As the Australian & New Zealand Journal of Psychiatry states, the criteria for the Personal Assessment and Crisis Evaluation clinic is now being utilized by many clinical research programs to see how beneficial it is for those with the prodromal criteria. Through this research, it is now possible that researchers can identify when people are at risk of developing schizophrenia (Yung et al, 2000). With this knowledge, we could possibly reduce the rate of schizophrenia by providing these services to those at risk. The ability to delay or prevent the development of schizophrenia can help many patients who will be diagnosed.

References:

Mejia, P. (2016, February 29). Schizophrenia Is Actually Eight Distinct Genetic Disorders: New
Study. Retrieved October 11, 2017, from
http://www.newsweek.com/schizophrenia-actually-eight-distinct-genetic-disorders-
According-new-study-271407

PACE (Personal Assessment and Crisis Evaluation). (n.d.). Retrieved October 13, 2017, from
http://oyh.org.au/our-services/clinical-program/
continuing-care-teams/pace-personal-assessment-and-crisis-evaluation

Parker, S., & Lewis, S. (2006). Identification of young people at risk of psychosis. Advances in
Psychiatric Treatment, 12, 249–255. Retrieved October 12, 2017, from
http://apt.rcpsych.org/content/aptrcpsych/12/4/249.full.pdf

Phillips, L. J., Yung, A. R., & McGorry, P. D. (2000, December 1). Identification of Young People
at Risk of Psychosis: Validation of Personal Assessment and Crisis Evaluation Clinic
Intake Criteria. Retrieved October 13, 2017, from
http://journals.sagepub.com/doi/abs/10.1080/000486700239?journalCode=anpa

The Free Dictionary by Farlex. (n.d.). Retrieved October 13, 2017, from
http://medical-dictionary.thefreedictionary.com/prodromal

Yung, A. R., McGorry, P. D., Francey, S. M., Nelson, B., Baker, K., Phillips, L. J., . . . Amminger,
G. P. (2007, October 01). PACE: a specialised service for young people at risk of
psychotic disorders. Retrieved October 11, 2017, from
https://www.mja.com.au/journal/2007/187/7/pace-specialised
-service-young-people-risk-psychotic-disorders

Yung, A. R., & Nelson, B. (2011). Young people at ultra high risk for psychosis: research from
the PACE clinic. Retrieved October 12, 2017, from
http://www.scielo.br/pdf/rbp/v33s2/03.pdf