Staging 2.0: refining transdiagnostic clinical staging frameworks to enhance reliability and utility for youth mental health.

Details

Serval ID
serval:BIB_9A8B0AEF609D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Staging 2.0: refining transdiagnostic clinical staging frameworks to enhance reliability and utility for youth mental health.
Journal
The lancet. Psychiatry
Author(s)
Scott J., Iorfino F., Capon W., Crouse J., Nelson B., Chanen A.M., Dwyer D., Conus P., Bechdolf A., Ratheesh A., Raballo A., Yung A., Berk M., McKenna S., Hockey S., Hutcheon A., Scott E., McGorry P., Shah J., Hickie I.B.
ISSN
2215-0374 (Electronic)
ISSN-L
2215-0366
Publication state
Published
Issued date
06/2024
Peer-reviewed
Oui
Volume
11
Number
6
Pages
461-471
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Globally, 75% of depressive, bipolar, and psychotic disorders emerge by age 25 years. However, these disorders are often preceded by non-specific symptoms or attenuated clinical syndromes. Difficulties in determining optimal treatment interventions for these emerging mental disorders, and uncertainties about accounting for co-occurring psychopathology and illness trajectories, have led many youth mental health services to adopt transdiagnostic clinical staging frameworks. In this Health Policy paper, an international working group highlights ongoing challenges in applying transdiagnostic staging frameworks in clinical research and practice, and proposes refinements to the transdiagnostic model to enhance its reliability, consistent recording, and clinical utility. We introduce the concept of within-stage heterogeneity and describe the advantages of defining stage in terms of clinical psychopathology and stage modifiers. Using examples from medicine, we discuss the utility of categorising stage modifiers into factors associated with progression (ie, potential predictors of stage transition) and extension (ie, factors associated with the current presentation that add complexity to treatment selection). Lastly, we suggest how it is possible to revise the currently used transdiagnostic staging approach to incorporate these key concepts, and how the revised framework could be applied in clinical and research practice.
Keywords
Humans, Adolescent, Mental Disorders/therapy, Mental Disorders/diagnosis, Reproducibility of Results, Young Adult, Mental Health Services/standards, Mental Health, Disease Progression, Adult
Pubmed
Create date
29/04/2024 10:42
Last modification date
25/05/2024 7:12
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