Abstract
Recent years have seen an advent in population-based studies in children, adolescents,
and adults that examine the prevalence, etiology, and developmental trajectories of
diverse subclinical psychopathological symptoms that pose a risk for the later development
of severe mental illnesses. It is increasingly recognized that most categorically
defined psychiatric disorders occur on a spectrum or continuum, show high heterogeneity
and symptom overlap, and share genetic and environmental risk factors. We discuss
neurodevelopmental underpinnings of psychosis spectrum symptoms and review brain morphometric
and functional alterations as well as genetic liability for psychosis in individuals
experiencing psychotic symptoms (PSs) in the general population. With regard to brain
structure and function, findings of qualitatively similar alterations in individuals
experiencing subthreshold PSs and individuals with overt psychotic disorders support
the notion of a psychosis continuum. However, genetic and epidemiological studies
have emphasized the overlap of PSs and other psychiatric illnesses. In particular,
PSs during adolescence appear to be a nonspecific precursor of different psychopathological
outcomes. Given the evidence presented in this review, we argue that findings from
population-based studies are appropriate to guide policy-making to further emphasize
public health efforts. Broadly accessible mental health programs are promising to
make a difference in the field of adolescent mental health. However, the specific
efficacy of these programs warrants further study, and caution is advised to not overpathologize
potentially transient occurrence of mental health problems.
Keywords
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Article info
Publication history
Published online: December 20, 2019
Accepted:
December 11,
2019
Received in revised form:
November 22,
2019
Received:
July 17,
2019
Identification
Copyright
© 2019 Society of Biological Psychiatry.
