At-Risk Mental States: Clinical Presentation and Psychopathological Comorbidities
A special issue of Clinics and Practice (ISSN 2039-7283).
Deadline for manuscript submissions: 30 November 2026 | Viewed by 21
Special Issue Editor
Special Issue Information
Dear Colleagues,
At-Risk Mental States (ARMSs) refer to a constellation of clinical conditions characterized by subthreshold psychotic symptoms and functional decline that indicate an increased risk for developing a psychotic disorder, particularly schizophrenia-spectrum disorders.
Frequently, individuals meeting criteria for At-Risk Mental States often seek help not primarily because of psychotic-like experiences but due to the distress and functional impairment associated with accompanying symptoms. Affective disturbances such as anxiety, depressive symptoms, emotional dysregulation, and heightened stress sensitivity are common drivers of help-seeking behavior. Difficulties in academic or occupational performance, social withdrawal, sleep disturbances, and a subjective sense of cognitive decline frequently prompt individuals or their families to seek clinical support. Attenuated psychotic symptoms are often experienced as confusing or anxiety-provoking rather than clearly pathological and may only emerge during clinical assessment. Consequently, help-seeking in ARMS populations reflects a broader need for relief from psychological distress and functional decline rather than a specific concern about developing psychosis, underscoring the importance of comprehensive, needs-based, early intervention strategies.
Moreover, psychopathological comorbidities are highly prevalent in ARMS populations and play a crucial role in clinical presentation and prognosis. Anxiety disorders, depressive disorders, and substance use disorders are the most commonly reported comorbid conditions, often predating or co-occurring with attenuated psychotic symptoms. These comorbidities contribute to symptom severity, distress, and help-seeking behavior, and may independently predict functional impairment and poorer outcomes. Additionally, negative symptoms and neurocognitive deficits frequently overlap with affective and anxiety symptomatology, complicating diagnostic assessment. Understanding the interplay between ARMSs and associated psychopathological comorbidities is essential for accurate risk stratification, early intervention, and the development of targeted, transdiagnostic treatment approaches aimed at improving long-term outcomes.
The aim of this Special Issue is to bring together the most recent evidence regarding the clinical presentation and psychopathological comorbidities of at-risk mental states. A more in-depth examination is needed to ensure accurate identification and differential diagnosis of these conditions.
Dr. Michele Ribolsi
Guest Editor
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Keywords
- at-risk mental state
- ultra high risk
- psychosis
- prodrome
- comorbidity
- subthreshold
- help seekers
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