Figure 2.

Putative model of the onset and progression of psychosis in relation to non-purely genetic risk factors and developmental processes affected by the disorder. Sociodemographic and parental risk factors and perinatal risk factors have been implicated during the preclinical phase, usually observed from birth to infancy, childhood, and early adolescence. Additional later factors occurring during later adolescence and early adulthood can trigger the onset of attenuated psychotic symptoms, functional impairment, and help-seeking behavior, which constitute the CHR-P stage. The diagnosis of psychosis, which operationally corresponds to the first episode of psychosis, is usually made during the adolescence or early adulthood, with a peak from 15 to 35 years. Once diagnosed, psychosis usually follows a fluctuating course punctuated by acute exacerbation of psychotic crises superimposed upon a background of poorly controlled negative, neurocognitive, and social cognitive symptoms. The pink boxes represent the risk factors for psychosis (16). FEP, First Episode Psychosis; CHR-P, Clinical High Risk for Psychosis.