The World Federation of Societies of Biological Psychiatry (WFSBP) and EPI Canada have recently released comprehensive psychosis prevention guidelines to standardise care for individuals at clinical high risk (CHR-P). These evidence-based recommendations aim to bridge the gap between initial risk identification and effective clinical intervention. By focusing on service organisation and targeted treatments, the guidelines provide a roadmap for reducing the global burden of psychotic disorders.

Service Organisation and Access

To ensure maximum impact, the guidelines suggest that prevention services should collaborate closely with early intervention teams. Specifically, they recommend an intake age between 14 and 35 years. Furthermore, clinics must remain accessible to individuals with cannabis use disorder, as this population often faces significant barriers to care. Consequently, integrated services can better address the duration of untreated illness.

Assessment and Communication Tools

Effective risk management requires specialised skills in clinical high-risk (CHR-P) assessment. Mental health staff should undergo rigorous training to administer and rate validated assessment tools accurately. Additionally, practitioners must maintain a human-to-human approach when discussing complex risk data with patients.

Implementing Risk Calculators in Psychosis Prevention Guidelines

A key highlight of the recommendations is the use of validated risk calculators. These tools help clinicians estimate the probability of transition to full psychosis with greater precision. However, the guidelines emphasise that these calculators should only complement, not replace, clinical judgment. Additionally, screening for comorbid mental disorders remains a vital component of the initial assessment process.

Evidence-Based Clinical Interventions

The guidelines advocate for a patient-centered approach following the \"first do no harm\" principle. Staff should offer evidence-based treatments for comorbid conditions and promote abstinence from cannabis. Treatment choices should ultimately reflect patient preferences while prioritising interventions that have the strongest evidence base for preventing transition.

Frequently Asked Questions

Who should be screened according to these guidelines?

The guidelines recommend screening individuals between the ages of 14 and 35 who show signs of clinical high-risk for psychosis.

What is the role of cannabis in psychosis prevention?

The guidelines specifically highlight the need for interventions that promote cannabis abstinence, as use is a significant risk factor for the development and progression of psychosis.

Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

1. Solmi M et al. Guidelines for the prevention of psychosis from the World Federation of Societies of Biological Psychiatry (WFSBP) and EPI Canada. World J Biol Psychiatry. 2026 May 27. doi: 10.1080/15622975.2026.2651738. PMID: 42201755.

2. Fusar-Poli P, et al. Preventing psychosis in people at clinical high risk: an updated meta-analysis. World Psychiatry. 2025;24(1):112-130.

3. National Institute for Health and Care Excellence (NICE). Psychosis and schizophrenia in adults: prevention and management. Clinical guideline [CG178]. 2014 (Updated 2024).