IMPACT OF EARLY INTERVENTIONS ON THE PROGNOSIS OF SCHIZOPHRENIA: A SYSTEMATIC REVIEW Introduction: Schizophrenia, a serious mental illness associated with functional and social impairments, has its prognosis significantly influenced by the timing of therapeutic intervention. Recent studies have highlighted that early approaches, implemented during the first psychotic episode (FEP), are correlated with lower relapse rates, reduction of negative symptoms, and improved social reintegration. Specialized programs, such as Early Psychosis Programs, combine pharmacotherapy, psychotherapy, and family support, but gaps remain in the understanding of their impact over extended timescales, especially in populations with limited access to health services. Objective: To analyze, through a systematic review, the impact of early interventions on the prognosis of patients with schizophrenia, considering clinical, functional, and social outcomes in long-term studies. Methodology: The review followed the PRISMA checklist, using the PubMed, SciELO, and Web of Science databases, with articles published in the last 10 years. The descriptors were: "early intervention in psychosis", "schizophrenia prognosis", "long-term outcomes", "first episode psychosis", and "psychosocial interventions". Longitudinal studies (follow-up ≥5 years), randomized clinical trials, and prospective cohorts that evaluated early interventions were included. Case studies, narrative reviews, and articles without quantitative outcome assessments were excluded. Methodological quality was assessed using tools such as the Newcastle-Ottawa scale. Results: Of the 1,237 studies identified, 15 met the criteria. Early intervention programs were associated with a 40% reduction in hospitalizations and a 30% improvement in cognitive function after 10 years. Multidisciplinary models, such as cognitive-behavioral therapy combined with antipsychotics, have demonstrated greater effectiveness in preventing relapses compared to usual treatment. Studies in middle-income countries have highlighted structural barriers, such as lack of access to second-generation medications, limiting the sustainability of interventions. Conclusion: Early interventions have proven crucial for improving long-term outcomes in schizophrenia, with robust evidence on reduced disability and hospital costs. However, effective implementation requires cultural adaptations and investments in public health, especially in resource-limited regions. The integration of biopsychosocial approaches emerges as a priority strategy to optimize the prognosis of this population. Early intervention in psychosis. Schizophrenia prognosis. Long-term outcomes. First episode psychosis and psychosocial interventions.

Abstract

Introduction: Schizophrenia, a serious mental illness associated with functional and social impairments, has its prognosis significantly influenced by the timing of therapeutic intervention. Recent studies have highlighted that early approaches, implemented during the first psychotic episode (FEP), are correlated with lower relapse rates, reduction of negative symptoms, and improved social reintegration. Specialized programs, such as Early Psychosis Programs, combine pharmacotherapy, psychotherapy, and family support, but gaps remain in understanding their impact over extended timescales, especially in populations with limited access to healthcare services. Objective: To analyze, through a systematic review, the impact of early interventions on the prognosis of patients with schizophrenia, considering clinical, functional, and social outcomes in long-term studies. Methodology: The review followed the PRISMA checklist, using the PubMed, SciELO, and Web of Science databases, with articles published in the last 10 years. The descriptors used were: "early intervention in psychosis", "schizophrenia prognosis", "long-term outcomes", "first episode psychosis", and "psychosocial interventions". Longitudinal studies (follow-up ≥5 years), randomized clinical trials, and prospective cohorts that evaluated early interventions were included. Case studies, narrative reviews, and articles without quantitative outcome assessments were excluded. Methodological quality was assessed using tools such as the Newcastle-Ottawa scale. Results: Of the 1,237 studies identified, 15 met the criteria. Early intervention programs were associated with a 40% reduction in hospitalizations and a 30% improvement in cognitive function after 10 years. Multidisciplinary models, such as cognitive-behavioral therapy combined with antipsychotics, demonstrated greater efficacy in preventing relapses compared to usual treatment. Studies in middle-income countries highlighted structural barriers, such as lack of access to second-generation medications, limiting the sustainability of interventions. Conclusion: Early interventions have proven crucial for improving long-term outcomes in schizophrenia, with robust evidence showing a reduction in disability and hospital costs. However, effective implementation requires cultural adaptations and investments in public health, especially in resource-limited regions. The integration of biopsychosocial approaches emerges as a priority strategy to optimize the prognosis of this population.