An Overview of Diagnostic and Clinical Considerations Pertaining to Psychosis-Risk Syndromes

Abstract

Early intervention in psychosis can provide significant clinical benefits for patients, but disambiguating risk states from a full-threshold illness—a prerequisite for informed clinical decision-making—can be challenging. This article overviews the assessment, phenomenology, and treatment of clinical high-risk (CHR) syndromes, a set of risk factors and symptoms that indicate substantially elevated risk for psychosis when presenting among help-seeking youth. Symptoms associated with CHR states often present as qualitatively similar to those of formal psychotic disorders and may be associated with distress and behavior change. However, insight has not been lost and behavior is not seriously disorganized or dangerous. The emerging nature of these symptoms in conjunction with the young age of patients at CHR and high levels of public stigma bring unique challenges to assessment, clinical feedback, and treatment. Nonetheless, there are numerous guidelines and standards that can support clinicians in providing high quality care for this important population. [ Psychiatr Ann . 2023;53(5):194–198.]