IntroductionTo date, among individuals meeting ultra-high risk criteria for psychosis, the relationship between the presence of anxiety disorders and the risk of psychotic transition raises several unanswered questions.Case descriptionThis case report describes the clinical progression of a 17-year-old male initially presenting anxious symptoms meeting the DSM-V criteria for panic disorder. The patient also reported social withdraw, mild depressive symptoms, insomnia and fatigue. Over a 6 month period, a gradual onset of subthreshold psychotic symptoms suggested a prodromal phase of a psychotic disorder.Diagnostic assessment and therapeutic interventionA detailed assessment of UHR criteria for psychosis was performed. The overall level of social and occupational functioning was assessed by the SOFAS, which showed a 35% drop over a 12 months period. The CAARMS, has also been administered. The patient met the diagnostic criteria for UHR, APS group. The care plan included psychiatric follow-up, pharmacologic treatment, individual psychological follow-up and individual and familial psychoeducation. Over a 6 months period, the patient did not experienced a first psychotic episode and presented a partial improvement of psychotic symptoms.ConclusionThe DSM-V categorical approach does not seem to adapt well to early clinical presentations in transitional age youth. A transdiagnostic and dimensional approach allows to better identify at-risk patients of psychiatric disorders and implement early intervention strategies.

BackgroundUnderstanding psychopathology in transitional age youth (TAY) requires a complex model, incorporating familial vulnerability and environmental factors. A trans-diagnostic and dimensional approach seems the most appropriate. Transition_psy study aims to assess factors playing a role in TAY psychopathology and to define predictors.Materials and methodsThis article presents part of the Transition_psy study results, a case-control observational study. Youth aged 17 years old were recruited between June 2020 and December 2021, from both clinical [clinical population (CP) group] and non-clinical settings [non-clinical population (NCP) group]. Participants completed self-report questionnaires. The primary outcome to assess TAY psychopathology was the Youth-Self Report (YSR). We evaluated care needs with the Health of The Nation Outcome Scales For Children And Adolescents (HoNOSCA-SR) and quality of life with the World Health Organization Quality of Life – BREF (WHOQoL-BREF). Exposure factors included familial vulnerability, childhood, and present environmental factors, such as first-degree family history of psychopathology, the Childhood Trauma Questionnaire (CTQ) and the Family Assessment Device (FAD). YSR scores were compared, between groups, according to exposure factors with ANOVA and linear regression. We performed best subsets selection of multivariable analyses based on the Akaike Information Criterion. This study was registered with ClinicalTrials.gov (Identifier: NCT04333797).ResultsA total of 220 TAY (CP = 106, NCP = 114) were included in the study. Participants were aged 17 years old. The majority were female (69.1%), single (96.8%), and born in Belgium (82.3%). Clinical data were all significantly different between CP and NCP groups. YSR scores were found statistically different according to group (p < 0.001), first-degree family history of psychopathology (p < 0.001), CTQ (p < 0.001), and FAD (p < 0.001). Predictive dimensional model suggested that TAY psychopathology can be predicted by group, CTQ and FAD. Significant positive correlation was found between YSR and HoNOSCA (rho = 0.81) and negative correlation between YSR and physical and psychological health (rho = −0.69 and −0.71, respectively).ConclusionThis study findings allowed to present a predictive dimensional model on TAY psychopathology, including belonging to a clinical population at transitional age, childhood trauma, and family dysfunction. Further research is needed to replicate Transition_psy study results in other samples. The proposed model could be used in clinical practice to improve assessment of TAY psychopathology.