{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T09:14:57Z","timestamp":1775553297907,"version":"3.50.1"},"reference-count":47,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The value of services for those with the \u2018At Risk Mental State for Psychosis\u2019 (ARMS) continues to be disputed. ARMS services have provided a valuable stimulus to academic research into the transition into psychosis. Furthermore, there is currently a welcome trend to transform such clinics into youth mental health services catering for the broader clientele of young people suffering from anxiety and depression, who already constitute the bulk of those seen at ARMS clinics. However, such services are never likely to make major inroads into preventing psychosis because they only reach a small proportion of those at risk. Evidence from medicine shows that avoiding exposure to factors which increase the risk of disease (e.g. poor nutrition, transmission of infection, tobacco smoking), produces greater public benefit than focussing efforts on individuals with, or about to develop, disease. We consider that the most productive approach for psychosis prevention is avoiding exposure to risk-increasing factors. The best-established risk factors for psychosis are obstetric events, childhood abuse, migration, city living, adverse life events and cannabis use. Some as city living, are likely proxies for an unknown causal factor(s) while preventing others such as childhood abuse is currently beyond our powers. The risk factor for psychosis which is most readily open to this approach is the use of cannabis. Therefore, as an initial step towards a strategy for universal primary prevention, we advocate public health campaigns to educate young people about the harms of regular use of high potency cannabis.<\/jats:p>","DOI":"10.1017\/s003329172000313x","type":"journal-article","created":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T06:18:24Z","timestamp":1599459504000},"page":"223-227","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":29,"title":["Prevention of psychosis: moving on from the at-risk mental state to universal primary prevention"],"prefix":"10.1017","volume":"51","author":[{"given":"Robin M.","family":"Murray","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony S.","family":"David","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3987-1236","authenticated-orcid":false,"given":"Olesya","family":"Ajnakina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"S003329172000313X_ref40","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201600304"},{"key":"S003329172000313X_ref36","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbx060"},{"key":"S003329172000313X_ref11","unstructured":"Centre for urban design and mental health (2020). www.urban designmentalhealth.com."},{"key":"S003329172000313X_ref20","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.3554"},{"key":"S003329172000313X_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(93)90202-F"},{"key":"S003329172000313X_ref19","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2011.20"},{"key":"S003329172000313X_ref41","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.178.40.s60"},{"key":"S003329172000313X_ref3","doi-asserted-by":"publisher","DOI":"10.1177\/0004867419873717"},{"key":"S003329172000313X_ref45","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.schbul.a006895"},{"key":"S003329172000313X_ref1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291718003859"},{"key":"S003329172000313X_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30048-3"},{"key":"S003329172000313X_ref15","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1813"},{"key":"S003329172000313X_ref27","doi-asserted-by":"publisher","DOI":"10.1177\/000486740003401S10"},{"key":"S003329172000313X_ref47","first-page":"1","article-title":"Counterpoint. Early intervention for psychosis risk syndromes: Minimizing risk and maximizing benefit","author":"Woods","year":"2020","journal-title":"Schizophrenia Research"},{"key":"S003329172000313X_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30057-9"},{"key":"S003329172000313X_ref18","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.1273"},{"key":"S003329172000313X_ref34","article-title":"The pro- and con-debate about the at-risk state and early intervention","author":"Nasrallah","year":"2020","journal-title":"Schizophrenia Research"},{"key":"S003329172000313X_ref26","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.4635"},{"key":"S003329172000313X_ref33","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.0339"},{"key":"S003329172000313X_ref44","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2009.12"},{"key":"S003329172000313X_ref25","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbw003"},{"key":"S003329172000313X_ref2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-017-1468-y"},{"key":"S003329172000313X_ref24","article-title":"Early intervention for psychosis risk syndromes: What are the real risks","author":"Malhi","year":"2020","journal-title":"Schizophrenia Research"},{"key":"S003329172000313X_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2018.12.111"},{"key":"S003329172000313X_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2006.11.018"},{"key":"S003329172000313X_ref35","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.0056"},{"key":"S003329172000313X_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbq122"},{"key":"S003329172000313X_ref17","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291719003532"},{"key":"S003329172000313X_ref43","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-019-1091-3"},{"key":"S003329172000313X_ref32","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7893.2010.00254.x"},{"key":"S003329172000313X_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2014.05.023"},{"key":"S003329172000313X_ref31","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291719001740"},{"key":"S003329172000313X_ref30","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291709005546"},{"key":"S003329172000313X_ref23","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201300236"},{"key":"S003329172000313X_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291710000723"},{"key":"S003329172000313X_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2015.08.001"},{"key":"S003329172000313X_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291706008440"},{"key":"S003329172000313X_ref37","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbi034"},{"key":"S003329172000313X_ref39","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-019-01812-9"},{"key":"S003329172000313X_ref29","first-page":"1","article-title":"Early intervention and youth mental health: Synergistic paradigms to transform mental health outcomes","author":"Mei","year":"2019","journal-title":"Innovations in Global Mental Health"},{"key":"S003329172000313X_ref7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7325.1336"},{"key":"S003329172000313X_ref42","doi-asserted-by":"publisher","DOI":"10.1038\/npjschz.2016.3"},{"key":"S003329172000313X_ref48","first-page":"1","article-title":"The reality of At risk mental state services: A response to recent criticisms","author":"Yung","year":"2019","journal-title":"Psychological Medicine"},{"key":"S003329172000313X_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2018.03.026"},{"key":"S003329172000313X_ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.0142"},{"key":"S003329172000313X_ref21","doi-asserted-by":"publisher","DOI":"10.5042\/jpmh.2010.0324"},{"key":"S003329172000313X_ref38","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.1634"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S003329172000313X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T12:32:20Z","timestamp":1616157140000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S003329172000313X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,7]]},"references-count":47,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["S003329172000313X"],"URL":"https:\/\/doi.org\/10.1017\/s003329172000313x","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,7]]},"assertion":[{"value":"Copyright \u00a9 The Author(s) 2020. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}