Conceptual issues in the classification of psychosis.
OBJECTIVE
To provide an update on the conceptual status of attenuated psychosis syndrome (APS) as a psychiatric disorder.


RESULTS
In May 2012, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Task Force announced that the planned introduction of APS as a new diagnosis in DSM-5 was cancelled and that APS was being moved to 'Section III' of the manual as a diagnostic construct requiring more work. Recent studies of APS have reflected this uncertainty and debate over its validity.


CONCLUSIONS
Before and after the decision in May 2012 to remove APS as a new diagnosis in DSM-5, scientific work has proceeded in a robust manner to shore up the validity of APS as a diagnostic construct. Recent work on APS has revolved around a series of unresolved questions: the actual incidence of conversion of APS to full-blown psychosis, the identification of the subgroup that will convert, the appropriate treatment for APS, the ability of treatment to prevent conversion to psychosis, the wide range of long-term outcomes of APS and finally the decision whether to include APS as a formal psychiatric diagnosis. Although the debate continues, a substantial number of the major researchers have argued that APS does not yet enjoy a degree of validity that warrants inclusion as a formal diagnosis.
Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06460, USA. james.phillips@yale.edu
James
J
Phillips
D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D011618:Psychotic Disorders / Q000145:classification* / Q000523:psychology