Early Identification of Psychiatric Disorders
Early detection and early intervention approach targets people at-risk stages who are very close to conversion to illness, or patients who have just transited the illness stage and have not, yet, become chronic. Rigorous efforts have been put in for early detection and early intervention in psychiatry. A high-risk population is identified by clinical manifestations that, as per their severity and suffering, do not yet meet the diagnostic criteria of psychiatric disorders. There have been attempts to break through the existing phenotype-based diagnostic system using biomarkers, but researchers have yet to overcome the heterogeneity of the disease. Nowadays, the clinical staging models in psychosis, bipolar, and depressive disorders have been proposed as a heuristic and a practical alternative to this. This model is evolving to integrate various demographic factors, clinical symptoms, cognitive functions, and biomarkers.
KeywordsEarly identification Heterogeneity Clinical staging Biomarkers Psychiatric disorders
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (Grant no. 2019R1A2B5B03100844).
- 3.McGorry PD, Killackey E, Yung A. Early intervention in psychosis: concepts, evidence and future directions. World Psychiatry Off J World Psychiatr Assoc WPA. 2008;7(3):148–56.Google Scholar
- 4.McGlashan TH, Zipursky RB, Perkins D, Addington J, Miller TJ, Woods SW, et al. The PRIME North America randomized double-blind clinical trial of olanzapine versus placebo in patients at risk of being prodromally symptomatic for psychosis. I. Study rationale and design. Schizophr Res. 2003;61(1):7–18.PubMedCrossRefPubMedCentralGoogle Scholar
- 29.Woods SW, Powers AR, Taylor JH, Davidson CA, Johannesen JK, Addington J, et al. Lack of diagnostic pluripotentiality in patients at clinical high risk for psychosis: specificity of comorbidity persistence and search for pluripotential subgroups. Schizophr Bull. 2018;44(2):254–63.PubMedCentralCrossRefGoogle Scholar
- 32.Hartmann JA, Nelson B, Spooner R, Paul Amminger G, Chanen A, Davey CG, et al. Broad clinical high-risk mental state (CHARMS): methodology of a cohort study validating criteria for pluripotent risk. Early Interv Psychiatry. 2017.Google Scholar
- 39.Jauhar S, Nour MM, Veronese M, Rogdaki M, Bonoldi I, Azis M, et al. A Test of the transdiagnostic dopamine hypothesis of psychosis using positron emission tomographic imaging in bipolar affective disorder and schizophrenia. JAMA Psychiatry. 2017;74(12):1206–13.PubMedPubMedCentralCrossRefGoogle Scholar
- 48.Addington J, Liu L, Goldstein BI, Wang J, Kennedy SH, Bray S, et al. Clinical staging for youth at-risk for serious mental illness. Early Interv Psychiatry. 2019.Google Scholar
- 49.Berendsen S, van der Paardt J, van Bruggen M, Nusselder H, Jalink M, Peen J, et al. Exploring construct validity of clinical staging in schizophrenia spectrum disorders in an acute psychiatric ward. Clin Schizophr Relat Psychoses. 2018.Google Scholar
- 55.McGorry PD, Hartmann JA, Spooner R, Nelson B. Beyond the “at risk mental state” concept: transitioning to transdiagnostic psychiatry. World Psychiatry Off J World Psychiatr Assoc WPA. 2018;17(2):133–42.Google Scholar
- 58.Fusar-Poli P, Solmi M, Brondino N, Davies C, Chae C, Politi P, et al. Transdiagnostic psychiatry: a systematic review. World Psychiatry Off J World Psychiatr Assoc WPA. 2019;18(2):192–207.Google Scholar
- 59.Fusar-Poli P, Oliver D, Spada G, Patel R, Stewart R, Dobson R, et al. Real world implementation of a transdiagnostic risk calculator for the automatic detection of individuals at risk of psychosis in clinical routine: study protocol. Front Psychiatry. 2019;10:109.PubMedPubMedCentralCrossRefGoogle Scholar
- 60.Fusar-Poli P, Werbeloff N, Rutigliano G, Oliver D, Davies C, Stahl D, et al. Transdiagnostic risk calculator for the automatic detection of individuals at risk and the prediction of psychosis: second replication in an independent national health service trust. Schizophr Bull. 2018.Google Scholar