The ultra high risk approach to define psychosis risk

Although prodromal symptoms of psychosis have long been recognized, the clinical management of psychotic disorders conventionally begins at the first episode of frank psychosis, and, until recently, the period immediately preceding the first episode received relatively little attention. Over the last fifteen years, there has been increasing academic and clinical interest in people presenting with potentially prodromal symptoms. This clinical syndrome has been termed an "At Risk Mental State", and operationalised criteria, the "Ultra High Risk (UHR)", or "Clinical High Risk" criteria, have been developed to identify the syndrome. We will review here the mainstreams of the UHR paradigms focusing on the conceptual basis, potentials and limitations in current psychiatric research.