Bridging the Phenomenology of Prodromal Psychosis with Its Underlying Neurobiological Mechanisms

Youths at risk for psychotic disorders present with indistinct clinical syndromes in the setting of functional difficulties. They frequently seek help from clinical services and possess compelling individual narratives. Clinical outcomes however usually only become clear after a year or two of longitudinal intensive clinical follow-up, as young individuals have diverse and dynamic trajectories, even from seemingly similar starting points. Here, the experience of use of a novel diagnostic method based upon functional MRI in addition to intensive clinical follow-up are described during the time I served as medical director of a prodromal psychosis clinical service in an urban medical center. By combining clinical observation with imaging technology, prediction of longitudinal outcomes, along with opportunity to apply tailored individual clinical intervention, appears feasible.