Psychotic Disorders and Risk-States in Adolescence: Etiology, Developmental Considerations, and Treatment

The progression to psychotic disorders such as schizophrenia typically begins in adolescence, and these illnesses can have lasting impacts on an individual, families, and society. Because of the overlap with this critical developmental period, those who develop formal psychotic disorders during adolescence require specialized considerations. Further, within the last two decades, efforts to understand and treat psychosis have also shifted to identifying those earlier on in progression, prior to onset. Psychosis risk-syndromes typically emerge in adolescence and are characterized by attenuated symptoms, as well as progressive cognitive and social decline. A significant subgroup of these youth will go on to develop a formal psychotic disorder in a short 2-year period, and this creates a unique opportunity for mechanistic understanding and early intervention as well as potential prevention efforts. With this article, we provide an overview of adolescent-onset psychosis as well as psychosis-risk syndromes, review conceptualizations, and evaluate prediction, early identification and treatment targets in a developmental context. Furthermore, current and future intervention options for both groups are discussed.