Cupo L, McIlwaine SV, Daneault JG, et al. - In prospective population studies, psychotic syndromes are suggested as an emergent phenomenon—a function of severity and complexity of more common mental health presentations and their nonpsychotic symptoms. Considering that valuable data to support or refute this conceptualization of how psychosis develops could be gained by determining the correlation between nonpsychotic and subthreshold psychotic symptoms in individuals who later developed a first episode of psychosis (FEP), researchers here performed a follow-back study comprised of semistructured interviews with 430 patients and families supplemented by chart reviews in a catchment-based sample of affective and nonaffective FEP. Both the first psychiatric symptom and the first prodromal symptom were more frequently pre-onset nonpsychotic (NPS) than subthreshold psychotic (STPS). Proportionally more of each NPS was identified in patients reporting pre-onset STPS relative to those without pre-onset STPS. Ultimately, a strong positive association was noted between NPS counts (reflecting complexity) and STPS counts. Before a FEP, NPS precede STPS, and greater complexity of NPS is noted to be linked with the presence and frequency of STPS. Complementing recent arguments, findings suggest that the emergence of psychotic illness is better conceptualized as part of a continuum—with implications for ascertaining pluripotential developmental trajectories and strengthening early intervention paradigms.