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Scope and limits of medicalization of the risk for psychosis: emergence of a new category?

This paper aimed to discuss the medicalization of the risk for psychosis, and more specifically, the building of a new diagnostic category which has been carried out by the DSM-5 elaboration Task Force, named psychosis risk syndrome and, more recently, attenuated psychotic symptoms syndrome. The methodology was the bibliographic review. A brief account on the genealogy of risk in pshychiatry was done. The initial part of the article sought to discuss the medicalization in a more general manner, focusing on aspects of social control and technologies of the self, under a Foucault-oriented approach. Subsequently, emphasis was given to the process of medicalization of the psychosis risk, particularly to the building of a category related to such risk. Within the reach of this process, the possibility of early intervention in the psychosis in order to retard its onset was emphasized. It is still unclear whether the early intervention can reduce the severity of the clinical status once already installed or even prevent its appearance. With respect to the limitations, the risk of producing hyper-medicalization with the building of the category, leading to indiscriminated usage of neuroleptic drugs and its related risks as well as the stigmatization of individuals included in this category were addressed. The problem of the high number of "false-positive" individuals, i.e. individuals which are included in the category and later do not develop any psychotic disorder, was also addressed. This paper attempted to produce a consistent review to the building of the nosological category under discussion.

medicalization; psychosis risk; DSM-5; nosological category


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