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Transdiagnostic clinical staging in youth mental health: a first international consensus statement.

  • Shah JL Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, QC, Canada.
  • Scott J Institute of Neuroscience, University of Newcastle, Newcastle upon Tyne, UK.
  • McGorry PD Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.
  • Cross SPM Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
  • Keshavan MS Massachusetts Mental Health Center and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
  • Nelson B Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.
  • Wood SJ Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.
  • Marwaha S Institute for Mental Health, University of Birmingham, Birmingham, UK.
  • Yung AR Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.
  • Scott EM Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
  • Öngür D Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Boston, MA, USA.
  • Conus P Treatment and Early Intervention in Psychosis Program (TIPP), Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
  • Henry C Perception and Memory Unit, Institut Pasteur, UMR3571, Centre National de la Recherche Scientifique (CNRS), Paris, France.
  • Hickie IB Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
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  • 2020-05-13
Published in:
  • World psychiatry : official journal of the World Psychiatric Association (WPA). - 2020
Clinical staging
extension
health services
heterotypy
homotypy
progression
service trans­formation
transdiagnostic
youth mental health
English Recognizing that current frameworks for classification and treatment in psychiatry are inadequate, particularly for use in young people and early intervention services, transdiagnostic clinical staging models have gained prominence. These models aim to identify where individuals lie along a continuum of illness, to improve treatment selection and to better understand patterns of illness continuity, discontinuity and aetiopathogenesis. All of these factors are particularly relevant to help-seeking and mental health needs experienced during the peak age range of onset, namely the adolescent and young adult developmental periods (i.e., ages 12-25 years). To date, progressive stages in transdiagnostic models have typically been defined by traditional symptom sets that distinguish "sub-threshold" from "threshold-level" disorders, even though both require clinical assessment and potential interventions. Here, we argue that staging models must go beyond illness progression to capture additional dimensions of illness extension as evidenced by emergence of mental or physical comorbidity/complexity or a marked change in a linked biological construct. To develop further consensus in this nascent field, we articulate principles and assumptions underpinning transdiagnostic clinical staging in youth mental health, how these models can be operationalized, and the implications of these arguments for research and development of new service systems. We then propose an agenda for the coming decade, including knowledge gaps, the need for multi-stakeholder input, and a collaborative international process for advancing both science and implementation.
Language
  • English
Open access status
gold
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Persistent URL
https://sonar.ch/global/documents/261570
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