A Clinical Perspective on Multidimensional Assessment of Clinical High-Risk States for Psychosis Beyond Transition Prediction
6 affiliations
- 1Discipline of Psychiatry II, Neurosciences Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- 2Clinical Department of Psychiatry, Central Military Emergency University Hospital “Dr. Carol Davila”, 010825 Bucharest, Romania
- 3Department of Psychiatry, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- 4Psychiatry Clinic, Craiova Clinical Hospital for Neuropsychiatry, 200473 Craiova, Romania
- 5Discipline of Psychiatry I, Neurosciences Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- 69th Department of Psychiatry, “Prof. Dr. Al. Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
Abstract
Background: Clinical high-risk states for psychosis (CHR-P) are associated with heterogeneous symptomatic and functional outcomes, only one of which is transition to psychosis. Objective: To propose a structured approach to current care needs and longitudinal clinical formulation alongside established syndromic assessment. Methods: This perspective integrates a targeted, non-systematic appraisal of instrument studies, evidence syntheses, longitudinal cohorts, and guidance with an explicitly author-proposed assessment architecture. Supplementary PubMed searches conducted during revision have been reported separately from the original search. Results: The framework retains validated CHR-P interviews as the syndromic anchor and organizes symptoms, functioning, cognition, comorbidity, developmental context, and longitudinal change into descriptive clinical profiles. A minimal clinical dataset is distinguished from optional structured assessments and investigational biological or digital measures. Descriptive profiles document source measures, current burden, change, and uncertainty without numerical weighting. A staged validation program prioritizes reproducibility, feasibility, and functioning, with transition assessed separately. Conclusions: The current framework offers a candidate structure for documenting needs and discussing care priorities; it does not establish prognostic accuracy or treatment benefit. Prospective evaluation is required before profile-based decisions based on this interpretative model can be recommended. A clinically useful approach to CHR-P research may need to move beyond reductionist conversion/non-conversion predictive models toward more calibrated, externally validated paradigms capable of predicting multiple clinically meaningful trajectories.
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BibTeX
@article{vasiliu2026clinical,
title = {{A Clinical Perspective on Multidimensional Assessment of Clinical High-Risk States for Psychosis Beyond Transition Prediction}},
author = {Octavian Vasiliu and Ileana Marinescu and Andrei G. Mangalagiu and Bogdan M. Petrescu and Adela M. Ciobanu},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207955},
url = {https://www.mdpi.com/2077-0383/15/20/7955},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A Clinical Perspective on Multidimensional Assessment of Clinical High-Risk States for Psychosis Beyond Transition Prediction
AU - Octavian Vasiliu
AU - Ileana Marinescu
AU - Andrei G. Mangalagiu
AU - Bogdan M. Petrescu
AU - Adela M. Ciobanu
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207955
UR - https://www.mdpi.com/2077-0383/15/20/7955
AB - Background: Clinical high-risk states for psychosis (CHR-P) are associated with heterogeneous symptomatic and functional outcomes, only one of which is transition to psychosis. Objective: To propose a structured approach to current care needs and longitudinal clinical formulation alongside established syndromic assessment. Methods: This perspective integrates a targeted, non-systematic appraisal of instrument studies, evidence syntheses, longitudinal cohorts, and guidance with an explicitly author-proposed assessment architecture. Supplementary PubMed searches conducted during revision have been reported separately from the original search. Results: The framework retains validated CHR-P interviews as the syndromic anchor and organizes symptoms, functioning, cognition, comorbidity, developmental context, and longitudinal change into descriptive clinical profiles. A minimal clinical dataset is distinguished from optional structured assessments and investigational biological or digital measures. Descriptive profiles document source measures, current burden, change, and uncertainty without numerical weighting. A staged validation program prioritizes reproducibility, feasibility, and functioning, with transition assessed separately. Conclusions: The current framework offers a candidate structure for documenting needs and discussing care priorities; it does not establish prognostic accuracy or treatment benefit. Prospective evaluation is required before profile-based decisions based on this interpretative model can be recommended. A clinically useful approach to CHR-P research may need to move beyond reductionist conversion/non-conversion predictive models toward more calibrated, externally validated paradigms capable of predicting multiple clinically meaningful trajectories.
SN - 2077-0383
ER -