Suggestions on early psychosis: towards a new psychopathology?

In recent years, mental health professionals have diffusely treated “early psychosis” (EP), an unspecified clinical condition characterized by the first manifestation of psychotic symptoms (especially hallucinations, delusions, and disorganized speech), including attenuated prodromal ones. This term is currently used for provisional diagnosis, with detailed categorical definitions pending. The term EP immediately recalls its clinical antecedents and prodromal symptoms, leading us back to the early detection and identification of the “At-Risk Mental States” (ARMSs) of psychosis. Although helpful for early treatments and reducing the duration of untreated psychosis, the EP conceptualization remains unclear, especially in its psychopathological trajectories. Does the term EP refer to the onset of its first functioning decline or to the instance first psychological distress or simply to the first contact with mental healthcare services? There is a “nebula” in which a multiplicity of psychopathological conditions may exist, often undefined and unspecified, sinking their roots very early in a patient’s life. In this paper, we discuss some suggestions to better understand this clinical complexity. Moreover, based on common clinical experiences, some hypotheses on development and change in the current EP methodological approach and intervention will be advanced. Finally, a different definition of “normality” (also taking into account the modern digital revolution, the current instability of the early life phases, and the increasingly poor confidence in the future) is proposed as an element characterizing the new young generations and a potential, broader interpretation of the EP conceptualization.