The idea that we can reduce the incidence of psychotic disorders through detection and intervention in the prodromal stage of illness has generated increasing enthusiasm and research over the past 2 decades. This work has sought largely to identify individual-level changes in subjective experience, functioning, or brain volume or activity that immediately precede acute symptom onset. However, mental illnesses, including psychotic disorders, are particularly sensitive to the social, political, cultural, and economic context within which an individual lives.¹ Prioritizing approaches to psychosis prevention that fail to give these social determinants a central role ignores compelling evidence and misses an opportunity to identify specific ways to help vulnerable youth.

在过去的20年中，我们可以通过在疾病的前驱阶段进行检测和干预来减少精神疾病的发生，这一想法引起了越来越多的热情和研究。这项工作主要是为了确定在急性症状发作之前的主观经验，功能或大脑容量或活动的个体水平变化。但是，包括精神病在内的精神疾病对个人所处的社会，政治，文化和经济环境特别敏感。¹优先预防精神病的方法未能使这些社会决定因素发挥中心作用，却忽略了有说服力的证据，并且错过了确定帮助弱势青年的具体方法的机会。