Psychosis risk syndrome and DSM-5: time for a dimensional approach to at-risk mental states?

The development of formal, empirically grounded methods for assessing At-Risk Mental States (ARMS) is becoming prominent, especially in light of the eventual inclusion of a pertinent "Psychosis risk syndrome" category in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Indeed, the phenomenology of risk syndromes for psychosis is complex, nuanced and clinically overlapping with multifarious transitory mental states. Supplementing current prodromal/Ultra-High Risk (UHR) criteria with a dimensional psychopathological approach would favor a rational mapping of emergent needs in ARMS help seekers and provide a more fine-grained reference framework for patient-centered risk stratification and intervention.