Abstract / Summary
This article reinterprets the DSM-5-TR child and adolescent psychosis profile through the SMART-NB methodology, proposing a multidimensional functional assessment beyond diagnostic classification. It examines positive and negative symptoms, thought and behavioral disorganization, cognition, executive functioning, school and social performance, sleep, autonomy, risk, medication effects, and longitudinal change. Particular emphasis is placed on differential diagnosis, including mood disorders, neurodevelopmental conditions, catatonia, epilepsy, autoimmune and other medical causes, substance-related presentations, and transient perceptual experiences. The objective is to distinguish psychotic symptoms from the functional and clinical mechanisms that shape their expression, providing a structured framework for individualized clinical priorities, safety assessment, and longitudinal intervention planning.