DSM-5 and the 'Psychosis Risk Syndrome': The need for a broader perspective

It has long been recognised that the need for care in psychiatry substantially precedes the point that a classical diagnosis can be assigned. While we can agree that there is a need to intervene well before severe and more intractable illness and collateral psychosocial damage supervenes, how do we define the initial clinical stages to guide early intervention? While we welcome the efforts of the DSM V committees to address this question with the proposal of the "psychosis risk syndrome", here we argue the case to expand this model to a phenotypically broad "pluripotential risk syndrome" that indicates a need for care without attempting to define an end-stage syndrome.