Individualized Diagnostic and Prognostic Models for Psychosis Risk Syndromes: Do Not Underestimate Antipsychotic Exposure

To the Editor: Research on clinical high risk for psychosis (CHR-P) is central for the early detection field and the deployment of suitable clinical care pathways aiming at preventing the consequences of psychosis. In the last decades, the field has been engaged in a robust effort to develop prognostic models for transdiagnostic staging and individualized risk stratification, as shown in the recent meta-analysis by Sanfelici et al. (1). However, in such vibrant yet tumultuous growth, the accelerated search for scalable predictors was not immune to disharmonies and involuntary distortions, such as the neglect of important clinical confounders. This is the case of baseline exposure to antipsychotics (APs) in individuals assessed for CHR-P state.