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Approximately 2% of adolescents and young adults display symptoms indicating a high risk for psychotic disorders. Apart from a risk of 20-35% of developing a psychotic disorder, these individuals show high rates of persisting mental health problems and functional impairment, even in the absence of a psychotic transition. Treatment in specialized centers can improve outcomes in these patients, but the need to provide timely access to care needs to be balanced against the risks of premature psychiatrization, stigmatization and unnecessary medication treatment. The transcantonal project PsyYoung aims to optimize early detection in young people, while at the same time minimizing unnecessary psychiatrization. This will be achieved through improved networking across the entire care chain and a stepped-care intervention approach., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

In this review of recent therapeutic developments in psychiatry, we will report on three domains where new strategies have been proposed. First we will discuss the concept of neuroprotection in patients at "ultra high risk" to develop psychosis and the encouraging results of a randomised controlled trial comparing the effect of placebo and fish oil. We will then present the impact of metacognition programs which aim at adding some flexibility to thought processes used by patients with psychosis in order to reduce psychotic symptoms. We finally will report on a program of supported employment which was developed in order to help patients find an active place in society.