Beyond the “at risk mental state” concept: transitioning to transdiagnostic psychiatry

World Psychiatry

Volumn 17, Issue 2, 2018, Pages 133-142

  McGorry, Patrick D ^a   Hartmann, Jessica A ^a   Spooner, Rachael ^a   Nelson, Barnaby ^a  

^a UNIVERSITY OF MELBOURNE   (Australia)

Author keywords

At risk mental state; CHARMS; clinical staging; dynamical systems theory; joint modelling; network theory; prediction strategies; psychosis; transdiagnostic psychiatry; transition; ultra high risk

Indexed keywords

ARTICLE; AT RISK MENTAL STATE; DYNAMICAL SYSTEMS THEORY; HIGH RISK PATIENT; HUMAN; MENTAL HEALTH; NETWORK THEORY; PREDICTION; PRIORITY JOURNAL; PSYCHIATRY; PSYCHOLOGICAL THEORY; PSYCHOSIS; RISK; STAGING; SYSTEMS THEORY; TRANSDIAGNOSTIC PSYCHIATRY; TRANSITIONAL CARE; ULTRA HIGH RISK PATIENT;

EID: 85047826836     PISSN: 17238617     EISSN: 20515545     Source Type: Journal    
DOI: 10.1002/wps.20514     Document Type: Article

References (93)

1. McGorry PD, Edwards J, Mihalopoulos C et al. EPPIC: an evolving system of early detection and optimal management. Schizophr Bull 1996;22:305-26.
2. McGorry PD, Copolov DL, Singh BS. Current concepts in functional psychosis. The case for a loosening of associations. Schizophr Res 1990;3:221-34.
3. Henry LP, Harris MG, Amminger GP et al. Early Psychosis Prevention and Intervention Centre long-term follow-up study of first-episode psychosis: methodology and baseline characteristics. Early Interv Psychiatry 2007;1:49-60.
4. Fusar-Poli P, Bonoldi I, Yung AR et al. Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry 2012;69:220-9.
5. Cannon TD. How schizophrenia develops: cognitive and brain mechanisms underlying onset of psychosis. Trends Cogn Sci 2015;19:744-56.
6. Wood SJ, Yung AR, McGorry PD et al. Neuroimaging and treatment evidence for clinical staging in psychotic disorders: from the at-risk mental state to chronic schizophrenia. Biol Psychiatry 2011;70:619-25.
7. van Os J, Guloksuz S. A critique of the “ultra-high risk” and “transition” paradigm. World Psychiatry 2017;16:200-6.
8. Cannon TD, Chung Y, He G et al. Progressive reduction in cortical thickness as psychosis develops: a multisite longitudinal neuroimaging study of youth at elevated clinical risk. Biol Psychiatry 2015;77:147-57.
9. McGorry P, Keshavan M, Goldstone S et al. Biomarkers and clinical staging in psychiatry. World Psychiatry 2014;13:211-23.
10. Pantelis C, Velakoulis D, McGorry PD et al. Neuroanatomical abnormalities before and after onset of psychosis: a cross-sectional and longitudinal MRI comparison. Lancet 2003;361:281-8.
11. Fusar-Poli P, McGuire P, Borgwardt S. Mapping prodromal psychosis: a critical review of neuroimaging studies. Eur Psychiatry 2012;27:181-91.
12. Cotter J, Drake RJ, Bucci S et al. What drives poor functioning in the at-risk mental state? A systematic review. Schizophr Res 2014;159:267-77.
13. Yung AR, Cotter J, Wood SJ et al. Childhood maltreatment and transition to psychotic disorder independently predict long-term functioning in young people at ultra-high risk for psychosis. Psychol Med 2015;45:3453-65.
14. Yung AR, Nelson B. The ultra-high risk concept – a review. Can J Psychiatry 2013;58:5-12.
15. Ruhrmann S, Schultze-Lutter F, Salokangas RK et al. Prediction of psychosis in adolescents and young adults at high risk: results from the Prospective European Prediction of Psychosis Study. Arch Gen Psychiatry 2010;67:241-51.
16. McGorry P, Nelson B. Why we need a transdiagnostic staging approach to emerging psychopathology, early diagnosis, and treatment. JAMA Psychiatry 2016;73:191-2.
17. Fusar-Poli P, Carpenter WT, Woods SW et al. Attenuated psychosis syndrome: ready for DSM-5.1? Annu Rev Clin Psychol 2014;10:155-92.
18. van der Gaag M, Smit F, Bechdolf A et al. Preventing a first episode of psychosis: meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups. Schizophr Res 2013;149:56-62.
19. McGorry PD, Nelson B, Markulev C et al. Effect of omega-3 polyunsaturated fatty acids in young people at ultrahigh risk for psychotic disorders: the NEURAPRO randomized clinical trial. JAMA Psychiatry 2017;74:19-27.
20. Stafford MR, Jackson H, Mayo-Wilson E et al. Early interventions to prevent psychosis: systematic review and meta-analysis. BMJ 2013;346:f185.
21. Yung AR. Treatment of people at ultra-high risk for psychosis. World Psychiatry 2017;16:207-8.
22. Yung AR, Nelson B, Thompson A et al. The psychosis threshold in ultra high risk (prodromal) research: is it valid? Schizophr Res 2010;120:1-6.
23. Nelson B, Amminger GP, Yuen HP et al. Staged Treatment in Early Psychosis: a sequential multiple assignment randomised trial of interventions for ultra high risk of psychosis patients. Early Interv Psychiatry (in press).
24. Polari A, Lavoie S, Yuen HP et al. Clinical trajectories in the ultra-high risk for psychosis population. Schizophr Res (in press).
25. Fusar-Poli P, Rocchetti M, Sardella A et al. Disorder, not just state of risk: meta-analysis of functioning and quality of life in people at high risk of psychosis. Br J Psychiatry 2015;207:198-206.
26. Carpenter WT, Regier D, Tandon R. Misunderstandings about attenuated psychosis syndrome in the DSM-5. Schizophr Res 2014;152:303.
27. Lin A, Wood SJ, Nelson B et al. Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis. Am J Psychiatry 2015;172:249-58.
28. Rutigliano G, Valmaggia L, Landi P et al. Persistence or recurrence of non-psychotic comorbid mental disorders associated with 6-year poor functional outcomes in patients at ultra high risk for psychosis. J Affect Disord 2016;203:101-10.
29. Cuijpers P. Examining the effects of prevention programs on the incidence of new cases of mental disorders: the lack of statistical power. Am J Psychiatry 2003;160:1385-91.
30. Lee TY, Lee J, Kim M et al. Can we predict psychosis outside the clinical high-risk state? A systematic review of non-psychotic risk syndromes for mental disorders. Schizophr Bull 2018;44:276-85.
31. Nelson B, Yuen HP, Wood SJ et al. Long-term follow-up of a group at ultra high risk (“prodromal”) for psychosis: the PACE 400 study. JAMA Psychiatry 2013;70:793-802.
32. Wigman JT, van Nierop M, Vollebergh WA et al. Evidence that psychotic symptoms are prevalent in disorders of anxiety and depression, impacting on illness onset, risk, and severity – implications for diagnosis and ultra-high risk research. Schizophr Bull 2012;38:247-57.
33. Lim J, Rekhi G, Rapisarda A et al. Impact of psychiatric comorbidity in individuals at ultra high risk of psychosis – findings from the Longitudinal Youth at Risk Study (LYRIKS). Schizophr Res 2015;164:8-14.
34. Shah JL, Crawford A, Mustafa SS et al. Is the clinical high-risk state a valid concept? Retrospective examination in a first-episode psychosis sample. Psychiatr Serv 2017;68:1046-52.
35. Frances A. Saving normal: an insider's revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life. New York: Morrow, 2013.
36. Greenberg G. The book of woe: the DSM and the unmaking of psychiatry. New York: Blue Rider, 2013.
37. Scott RD. The treatment barrier: part 2. The patient as an unrecognized agent. Br J Med Psychol 1973;46:57-67.
38. Eaton WW. The sociology of mental disorders, 3rd ed. Westport: Praeger, 2001.
39. McGorry P, van Os J. Redeeming diagnosis in psychiatry: timing versus specificity. Lancet 2013;381:343-5.
40. van Os J. The dynamics of subthreshold psychopathology: implications for diagnosis and treatment. Am J Psychiatry 2013;170:695-98.
41. van Os J, Linscott RJ, Myin-Germeys I et al. A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychol Med 2009;39:179-95.
42. Kelleher I, Corcoran P, Keeley H et al. Psychotic symptoms and population risk for suicide attempt: a prospective cohort study. JAMA Psychiatry 2013;70:940-8.
43. Kelleher I, Devlin N, Wigman JT et al. Psychotic experiences in a mental health clinic sample: implications for suicidality, multimorbidity and functioning. Psychol Med 2013;44:1615-24.
44. Kelleher I, Keeley H, Corcoran P et al. Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies. Br J Psychiatry 2012;201:26-32.
45. Kirmayer L, Lemelson R, Cummings C (eds). Revisioning psychiatry: integrating biological, clinical and cultural perspectives. Cambridge: Cambridge University Press, 2015.
46. Pilowsky I. Abnormal illness behaviour. Br J Med Psychol 1969;42:347-51.
47. Pilowsky I. A general classification of abnormal illness behaviours. Br J Med Psychol 1978;51:131-7.
48. Parnas J. The RDoC program: psychiatry without psyche? World Psychiatry 2014;13:46-7.
49. Borsboom D, Cramer A, Kalis A. Brain disorders? Not really… Why network structures block reductionism in psychopathology research. Behav Brain Sci (in press).
50. Nelson B, Hartmann JA, Parnas J. Detail, dynamics and depth: useful correctives for some current research trends. Br J Psychiatry (in press).
51. Lahey BB, Krueger RF, Rathouz PJ et al. Validity and utility of the general factor of psychopathology. World Psychiatry 2017;16:142-3.
52. Sanislow CA. Updating the Research Domain Criteria. World Psychiatry 2016;15:222-3.
53. Kotov R, Krueger RF, Watson D. A paradigm shift in psychiatric classification: the Hierarchical Taxonomy Of Psychopathology (HiTOP). World Psychiatry 2018;17:24-5.
54. McGorry PD. Issues for DSM-V: clinical staging: a heuristic pathway to valid nosology and safer, more effective treatment in psychiatry. Am J Psychiatry 2007;164:859-60.
55. McGorry PD. Early clinical phenotypes, clinical staging, and strategic biomarker research: building blocks for personalized psychiatry. Biol Psychiatry 2013;74:394-5.
56. Ajnakina O. First episode psychosis: looking backwards and forwards. London: King's College London, 2017.
57. Yung AR, Yuen HP, Berger G et al. Declining transition rate in ultra high risk (prodromal) services: dilution or reduction of risk? Schizophr Bull 2007;33:673-81.
58. Valmaggia LR, Byrne M, Day F et al. Duration of untreated psychosis and need for admission in patients who engage with mental health services in the prodromal phase. Br J Psychiatry 2015;207:130-4.
59. Valmaggia LR, McCrone P, Knapp M et al. Economic impact of early intervention in people at high risk of psychosis. Psychol Med 2009;39:1617-26.
60. Phillips LJ, Cotton S, Mihalopoulos C et al. Cost implications of specific and non-specific treatment for young persons at ultra high risk of developing a first episode of psychosis. Early Interv Psychiatry 2009;3:28-34.
61. Savill M, D'Ambrosio J, Cannon TD et al. Psychosis risk screening in different populations using the Prodromal Questionnaire: a systematic review. Early Interv Psychiatry 2018;12:3-14.
62. Rietdijk J, Klaassen R, Ising H et al. Detection of people at risk of developing a first psychosis: comparison of two recruitment strategies. Acta Psychiatr Scand 2012;126:21-30.
63. PSYSCAN. Translating neuroimaging findings from research into clinical practice. http://psyscan.eu.
64. PRONIA. Personalised prognostic tools for early psychosis management. https://www.pronia.eu.
65. Clark SR, Baune BT, Schubert KO et al. Prediction of transition from ultra-high risk to first-episode psychosis using a probabilistic model combining history, clinical assessment and fatty-acid biomarkers. Transl Psychiatry 2016;6:e897.
66. Rickwood DJ, Telford NR, Mazzer KR et al. The services provided to young people through the headspace centres across Australia. Med J Aust 2015;202:533-6.
67. Rickwood DJ, Telford NR, Parker AG et al. headspace - Australia's innovation in youth mental health: who are the clients and why are they presenting? Med J Aust 2014;200:108-11.
68. Purcell R, Jorm AF, Hickie IB et al. Demographic and clinical characteristics of young people seeking help at youth mental health services: baseline findings of the Transitions Study. Early Interv Psychiatry 2015;9:487-97.
69. Shah JL. Sub-threshold mental illness in adolescents: within and beyond DSM's boundaries. Soc Psychiatry Psychiatr Epidemiol 2015;50:675-7.
70. Hartmann JA, Nelson B, Spooner R et al. Broad clinical high-risk mental state (CHARMS): methodology of a cohort study validating criteria for pluripotent risk. Early Interv Psychiatry (in press).
71. van Os J, Murray RM. Can we identify and treat “schizophrenia light” to prevent true psychotic illness? BMJ 2013;346:f304.
72. Power L, Polari AR, Yung AR et al. Distress in relation to attenuated psychotic symptoms in the ultra-high-risk population is not associated with increased risk of psychotic disorder. Early Interv Psychiatry 2015;10:258-62.
73. Lei H, Nahum-Shani I, Lynch K et al. A “SMART” design for building individualized treatment sequences. Annu Rev Clin Psychol 2012;8:21-48.
74. Nelson B, McGorry PD, Wichers M et al. Moving from static to dynamic models of the onset of mental disorder. JAMA Psychiatry 2017;74:528-34.
75. Scheffer M. Critical transitions in nature and society. Princeton: Princeton University Press, 2009.
76. Borsboom D. A network theory of mental disorders. World Psychiatry 2017;16:5-13.
77. Scheffer M, Carpenter SR, Lenton TM et al. Anticipating critical transitions. Science 2012;338:344-8.
78. van de Leemput IA, Wichers M, Cramer AO et al. Critical slowing down as early warning for the onset and termination of depression. Proc Natl Acad Sci USA 2014;111:87-92.
79. Bayani A, Hadaeghi F, Jafari S et al. Critical slowing down as an early warning of transitions in episodes of bipolar disorder: a simulation study based on a computational model of circadian activity rhythms. Chronobiol Int 2017;34:235-45.
80. Scheffer M. Complex systems: foreseeing tipping points. Nature 2010;467:411-2.
81. Scheffer M, Bascompte J, Brock WA et al. Early-warning signals for critical transitions. Nature 2009;461:53-9.
82. Borsboom D, Cramer AO. Network analysis: an integrative approach to the structure of psychopathology. Annu Rev Clin Psychol 2013;9:91-121.
83. van Borkulo C, Boschloo L, Borsboom D et al. Association of symptom network structure with the course of longitudinal depression. JAMA Psychiatry 2015;72:1219-26.
84. Isvoranu AM, Borsboom D, van Os J et al. A network approach to environmental impact in psychotic disorder: brief theoretical framework. Schizophr Bull 2016;42:870-3.
85. Wigman JTW, van Os J, Thiery E et al. Psychiatric diagnosis revisited: towards a system of staging and profiling combining nomothetic and idiographic parameters of momentary mental states. PLoS One 2013;8:e59559.
86. Booij SH, Wichers M, de Jonge P et al. Study protocol for a prospective cohort study examining the predictive potential of dynamic symptom networks for the onset and progression of psychosis: the Mapping Individual Routes of Risk and Resilience (Mirorr) study. BMJ Open 2018;8:e019059.
87. Yuen HP, Mackinnon A. Performance of joint modelling of time-to-event data with time-dependent predictors: an assessment based on transition to psychosis data. PeerJ 2016;4:e2582.
88. Yuen HP, Mackinnon A, Nelson B. A new method for analysing transition to psychosis: joint modelling of time-to-event outcome with time-dependent predictors. Int J Methods Psychiatry Res (in press).
89. Yuen HP, Mackinnon A, Hartmann J et al. A novel approach for developing prediction models of transition to psychosis: dynamic prediction using joint modelling. Submitted for publication.
90. Cannon TD, Yu C, Addington J et al. An individualized risk calculator for research in prodromal psychosis. Am J Psychiatry 2016;173:980-8.
91. Fusar-Poli P, Rutigliano G, Stahl D et al. Development and validation of a clinically based risk calculator for the transdiagnostic prediction of psychosis. JAMA Psychiatry 2017;74:493-500.
92. Chitty RN. Why clinicians are natural bayesians: is there a bayesian doctor in the house? BMJ 2005;330:1390.
93. Bhatt DL, Mehta C. Adaptive designs for clinical trials. N Engl J Med 2016;375:65-74.