**1. Introduction**

Schizophrenia is a heterogenous disorder presenting as episodes of psychosis against a background of cognitive, social, and functional impairments.

Schizophrenia, a multifaceted neuropsychiatric disorder, is affecting approximately 1% of the population worldwide. Its onset is the result of a complex interplay of genetic predisposition and environmental factors.

After more than 100 years of studies and clinical psychiatric practice, passing through numerous conceptualizations of psychosis and schizophrenia, research tries to achieve an evolutionary pattern of psychosis and to establish clear, distinctive diagnostic criteria for every type of psychosis.

Psychosis is unanimously considered essential for understanding the evolution and treatment process and also for estimation of prognosis.

Recently, the area of "prodromal" research in schizophrenia and related disorders has grown considerably. From initial retrospective studies of this phase, dating back to the early twentieth century, the last decade of the century has seen the beginning and expansion of prospective studies aiming to identify the earliest manifestations of psychotic illnesses. From identification of these prodromal or "ultrahigh-risk"(UHR) individuals, the area has also developed to include intervention studies aiming to prevent, delay, or ameliorate the onset of a full-blown psychotic disorder and to investigate underlying processes that cause or contribute to the onset [1].

The fact that psychosis disorders, such as schizophrenia, begin with a prodromal phase prior to the onset of frank psychotic symptoms has been known since the first description of the illness was documented [1].

The pattern of psychosis and of the first episode of psychosis is similar to the pattern of schizophrenia but more complex.

Strauss and Carpenter considered that schizophrenia includes an interactive, developmental, and systematic model [2–6]. By analogy, the model of the first psychotic episode can be considered an interactive, developmental, and systematic model.

The arguments to sustain this theory (hypothesis) are:


Due to the complexity and heterogeneity of the first psychotic episode, to conceive and to unanimously recognize it like a coherent and unitary model are extremely difficult. The unknowns of this huge puzzle are still numerous despite the scientific efforts.

The model of the first psychotic episode has a medium- or long-term impact on schizophrenia model and can be of particular relevance to both etiopathogenesis and treatment as well as prevention strategies.

Over the last years, the most exciting signs of progress in defining a new conceptualization of psychosis are reported by the genomic studies [8, 9]. Maps of the neurobiological circuits of cognitive functions have been designed and have tried to explain the ways in which these circuits become dysfunctional in various disorders including the psychotic ones.

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*Schizophrenia: Early Recognition and Prevention DOI: http://dx.doi.org/10.5772/intechopen.88537*

period when the cortex is still in development.

biological dysfunctions long before psychosis.

Researchers from the National Institute of Mental Health (NIMH) have reported

1.Psychosis is a neurodevelopmental disorder, with onset in adolescence and

2.For most disorders related to the cortical functions, the changes of cognitive and comportamental fields appear (occur) later, suggesting the existence of

3.Psychosis like other complex diseases has a multifactorial determinism.

These data have facilitated the explanations of the pattern of psychosis by integrating molecular biology, neuroscience, and behavioral sciences. This new approach tries to discover finally the new treatment strategies including new medications (antipsychotics) and psychological, social, and other potential

The work group for psychosis within DSM-V proposes distinct clinical domains

In 2009 Jim van Os, one of the members of work group for psychosis, proposed a new syndrome named "salience dysregulation syndrome" as a diagnostic to be

Jim van Os used the psychotic model of Kapur who considers that hallucinations and delusional ideas appear because the individual has difficulties in recognizing his or her mental experience relevance. Jim van Os used the term syndrome not disease, because a syndrome is a set of symptoms that appear simultaneous without having a common cause. The symptoms described are positive and negative symptoms, disorganization, developmental cognitive deficits, and depressive and

The "salience dysregulation syndrome" was divided for diagnosis into:

b."Salience dysregulation syndrome with affective expression"

c. "Salience dysregulation syndrome not otherwise specified" [11]

a."Salience dysregulation syndrome with developmental cognitive deficits"

In 2010, Dominguez and collaborators [12] also members of work group for

• Deconstructing psychosis/schizophrenia disorganization considered as a

• The attenuation of psychotic symptoms is a favorable predictor for the outcome.

In his study [12], Dominguez considered that the association of negative symptoms or of the disorganization with attenuated psychotic symptoms increases the

for each psychotic disorder correlated with the neuronal circuits [10].

**2. Description of psychosis**

three conclusions:

interventions.

used [11].

maniacal symptoms [11].

**3. Attenuated syndrome**

syndrome.

psychosis described two new innovative aspects:

risk of developing a psychotic frank syndrome.
