Psychosis in Emerging Adulthood: Phenomenological, Diagnostic, and Clinical Considerations

Psychotic-spectrum disorders are serious illnesses that impact numerous individuals worldwide and often lead to significant functional impairment. Given a robust body of literature indicating that specialized care delivered to individuals within the first few years of a psychotic illness has substantial benefit, increased emphasis has been placed on early detection and intervention. To further refine the recognition, diagnosis, and treatment of individuals with psychosis, efforts are under way to improve our understanding of the unique developmental context of the phase of life in which psychotic illnesses are most likely to manifest—the late teenage to early adult years. Emerging adulthood, which spans these same years, has been recognized as a distinct developmental phase marked by exploration of identity and navigation of transitions and uncertainty. Thus, considering the symptom presentation of psychotic illnesses through the developmental lens of emerging adulthood provides an important opportunity to more comprehensively appreciate the nuances of how these illnesses may present during a phase of life already marked by change, unpredictability, and ongoing development of identity. The current article provides a review of presenting symptoms and diagnostic considerations through a developmentally informed perspective, with particular emphasis on clinical issues most relevant to emerging adults experiencing the recent onset of a psychotic illness.