Attenuated Psychosis Syndromes Among Brazilian Youth and Young Adults: Early Identification and Intervention

  • Graccielle R. Cunha
  • Elson M. Asevedo
  • Elisa Brietzke
  • Rodrigo A. Bressan
  • Ary Gadelha


Although research in early stages of mental disorders has been consistently increasing in Brazil, most findings are related to neurobiological processes associated with ultrahigh risk symptoms. Alterations in sleep patterns and peripheral blood biomarkers have been the main focus of original papers. There is currently no cohesive strategy for addressing this issue in the public health system, and the only existing service is linked to a university, PRISMA (Program of Recognition and Intervention in At-Risk Mental States subjects), a center providing specialized assessment and care for help-seeking individuals presenting with an attenuated psychosis syndromes (APS). The center is located in a central region of São Paulo functioning inside the Schizophrenia Program from the Federal University of São Paulo (UNIFESP).

Brazil has a very heterogenic and diverse population. In this context, instead of facing particular culturally relevant assessment and intervention approaches, the primary challenge is the multifaceted clinical presentation and inconsistent resources available for treatment. Furthermore, the nature of recent reforming of the Brazilian psychiatric system, a general lack of available services, limited access to specialized literature in the public health system, and inadequate mental health literacy among the general population may represent barriers to referrals. Several strategies have been implemented to improve referrals, like contact between PRISMA and primary healthcare services, training programs for teachers, lectures and partnerships with psychology clinics from other universities, and training programs for psychiatric residents during their formal academic education. Collaboration with other programs around the world has been critical to strengthening research and clinical knowledge.


Psychosis At-risk mental states Ultra high risk Adolescents Attenuated psychosis syndromes 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Graccielle R. Cunha
    • 1
  • Elson M. Asevedo
    • 1
  • Elisa Brietzke
    • 1
  • Rodrigo A. Bressan
    • 1
  • Ary Gadelha
    • 1
  1. 1.Universidade Federal de São PauloSão PauloBrazil

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