DSM‐5 and the ‘Psychosis Risk Syndrome’: Babylonic confusion

Abstract

The notion that the important paradigm shift in clinical psychiatry, associated with early intervention, should now become a diagnostic issue is misguided. The ‘risk’ in Psychosis Risk Syndrome will not make sense to treatment‐seeking patients with distressing symptoms and real need for care, is based on the notion that labeling people with invalid diagnostic terms has more clinical relevance than simply addressing care needs, is contingent on elusive sampling strategies posing as precise diagnostic criteria, and is associated with a false‐positive rate of at least 90% in the year after diagnosis. In the 21^st century, opinion‐based diagnostics continues to pose a threat to the process of diagnostic revision.

Keywords:

• Psychosis
• Diagnosis
• Risk
• Schizophrenia
• DSM‐5

Acknowledgements

Nil Kaymaz was supported by the Netherlands Organisation for Scientific Research (NWO), project number: 017.002.048. Jim van Os is member of the APA DSM‐V Psychotic Disorders Work Group. The views expressed are his own.