Background: In the future, clinicians might use information about neurobiological processes, obtained through imaging techniques, to guide personalized prevention and intervention strategies for psychosis and related disorders. However, this requires more knowledge about these individuals’ brain function.

Aim: To advance the current knowledge on neurobiological processes in patients with schizophrenia spectrum disorders (SSD) and individuals at increased risk of these disorders.

Method: We conducted a systematic review to address dopaminergic alterations in individuals at increased risk of SSD. Additionally, we acquired PET and MRI scans in patients with SSD and controls to obtain information about neurotransmitters, such as dopamine.

Results: Striatal dopamine synthesis capacity was altered in individuals at increased risk of developing SSD compared to controls. In healthy volunteers, the concentration of neuromelanin, a breakdown product of dopamine, in the substantia nigra was negatively associated with striatal dopamine synthesis capacity. This was not the case for patients with SSD.

Conclusion: We report differences in neurobiological processes and their interrelationships between patients with psychotic and related disorders and controls. This information may help predict psychosis susceptibility and treatment effectiveness in the future. Our findings can therefore contribute to the development of personalized treatments and better counselling of the patient.

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