Attenuated Psychosis Syndrome

[Page 356]Schizophrenia is often considered a young adult–onset disorder because the signs and symptoms used in diagnosis usually appear at ages 17 to 30 years. Prodromal symptoms or earlier morbid features precede diagnosis, usually by years. Since the 1990s, investigators have organized information on early morbid manifestations to define risk for progression to full psychosis. This work in expert centers, based on somewhat different terminology (e.g., clinical high risk, ultra high risk, at-risk mental state, attenuated psychosis syndrome [APS]), has produced extensive validating data, including elevated probability of progression to full psychosis, impaired cognition, negative symptoms, impaired function, and neuroimaging findings regarding gray matter, white matter, neurochemistry, and functional measures.

Random assignment clinical trials from 2004 onward suggest that experimental treatment is superior to treatment as ...