Cited by 409Mental Health Research TopicsPersonality Disorders and PsychopathologyAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Transdiagnostic psychiatry: a systematic review

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Fusar‐Poli, Paolo, Solmi, Marco, Brondino, Natascia, Davies, Cathy, Chae, Chungil, Politi, Pierluigi, Borgwardt, Stefan, Lawrie, Stephen M., Parnas, Josef, McGuire, Philip·2019·World Psychiatry

DOI 10.1002/wps.20631PMC PMC6502428

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Abstract

The usefulness of current psychiatric classification, which is based on ICD/DSM categorical diagnoses, remains questionable. A promising alternative has been put forward as the “transdiagnostic” approach. This is expected to cut across existing categorical diagnoses and go beyond them, to improve the way we classify and treat mental disorders. This systematic review explores whether self‐defining transdiagnostic research meets such high expectations. A multi‐step Web of Science literature search was performed according to an a priori protocol, to identify all studies that used the word “transdiagnostic” in their title, up to May 5, 2018. Empirical variables which indexed core characteristics were extracted, complemented by a bibliometric and conceptual analysis. A total of 111 studies were included. Most studies were investigating interventions, followed by cognition and psychological processes, and neuroscientific topics. Their samples ranged from 15 to 91,199 (median 148) participants, with a mean age from 10 to more than 60 (median 33) years. There were several methodological inconsistencies relating to the definition of the gold standard (DSM/ICD diagnoses), of the outcome measures and of the transdiagnostic approach. The quality of the studies was generally low and only a few findings were externally replicated. The majority of studies tested transdiagnostic features cutting across different diagnoses, and only a few tested new classification systems beyond the existing diagnoses. About one fifth of the studies were not transdiagnostic at all, because they investigated symptoms and not disorders, a single disorder, or because there was no diagnostic information. The bibliometric analysis revealed that transdiagnostic research largely restricted its focus to anxiety and depressive disorders. The conceptual analysis showed that transdiagnostic research is grounded more on rediscoveries than on true innovations, and that it is affected by some conceptual biases. To date, transdiagnostic approaches have not delivered a credible paradigm shift that can impact classification and clinical care. Practical “TRANSD”iagnostic recommendations are proposed here to guide future research in this field.

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BackgroundMethod
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“A transdiagnostic approach in psychiatry promises to overcome the limits of categorial diagnostic classification systems of mental illness and to improve clinical care and treatment [1].”
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“Mapping transdiagnostic and diagnosis-speciﬁc neurodevelopmental network abnormalities in MDD and SCH has important implications for understanding shared and unique neural mechanisms underlying the diseases (Fusar-Poli et al., 2019; McGorry et al., 2018; van den Heuvel and Sporns, 2019).”
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“At its core, utilizing a transdiagnostic perspective involves rejecting the DSM’s use of a categorical taxonomy to describe psychological disorders and instead considering underlying symptoms and traits that cut across diagnostic categories and inform human suffering (Fusar-Poli et al., 2019).”
Background
The trans-theoretical model for mindful cognitive behavioral therapy a paradigm for systematically advancing evidence-based practice and research
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“This reinforces the notion of a continuum between the psychiatric entities categorized in the DSM-5 [48], especially with regard to transdiagnostic models [49].”
Background
Psychopathological knowledge and methodically sound diagnostics are core elements of forensic psychiatry
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“A growing consensus in both research and clinical practice emphasizes the importance of adopting a transdiagnostic and holistic approach toward the care of people with mental health disorders [1, 2].”
BackgroundSelf-citation
Rethinking Mental Health
Wang, P., Zhao, M., & Liu, W. (2025) · Advances in Psychiatry and Behavioral Health · doi:10.1016/j.ypsc.2025.01.003 · Cited by 3
Psychological Transdiagnostic Processes in Mild Traumatic Brain Injury Recovery: A Scoping Review
Courchesne, C., Nair, M. A., Gelineau, M., McCloskey, L., Faulkner, J. W., & Cairncross, M. (2025) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2025.07.014 · Cited by 3
The WHO's Global Clinical Practice Network and the ICD‐11 implementation
Piegari, G. (2021) · World Psychiatry · doi:10.1002/wps.20866 · Cited by 4
Editorial: Novel antipsychotics within and beyond clinical trials: The treatment of overlapping psychiatric disorders with D3-D2 partial agonists
Németh, G., & Csehi, R. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1038627 · Cited by 3
What kind of «thing» is mental illness? Listening to Kraepelin, Jaspers and Kronfeld
Hoff, P. T. (2024) · International Review of Psychiatry · doi:10.1080/09540261.2024.2356690 · Cited by 2
Psychopathologie: operationalisiertes Werkzeug oder „Denkstil“?
Hoff, P. T. (2024) · Forensische Psychiatrie Psychologie Kriminologie · doi:10.1007/s11757-024-00851-6 · Cited by 2
Emotional Disorders, Distress Tolerance and Suicide Risk: A Mediation Model
Antuña‐Camblor, C., Esteller-Collado, G., Muñoz‐Navarro, R., Rabito-Alcón, M. F., & Rodríguez‐Díaz, F. J. (2024) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228241299287 · Cited by 4
Evaluation of a transdiagnostic mental health intervention in German primary care: study protocol for a parallel-group, two-arm, cluster randomised controlled pilot study
Ebert, C., Vogel, M., Gensichen, J., Reif, H., Grögor, L., Junker, L., Ehring, T. W., Hasan, A., Leucht, S., Lochbühler, K., et al. (2025) · Pilot and Feasibility Studies · doi:10.1186/s40814-025-01597-6 · Cited by 2
“The focus is thus shifted from differences between mental disorders to their similarities, so that shared mechanisms (i.e., transdiagnostic factors) can be identified and used for assessment and treatment [16].”
Transdiagnostic early warning score for psychiatric hospitalisation: development and evaluation of a prediction model
Taquet, M., Fazel, S., & Rush, A. J. (2025) · BMJ Mental Health · doi:10.1136/bmjment-2025-301622 · Cited by 2
What was done for youths aged 15 to 24 around the world? A systematic review of worldwide mental health interventions
Lee, M. H. M. H., Yap, K. H., & Ho, M. R. (2025) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2025.10042 · Cited by 2
“However, like the disorder perspective, the transdiagnostic approach also has limitations, where one significant drawback is its lack of a clear phenomenological framework, which can be ambiguous and lacking specificity (Fusar-Poli et al., 2019).”
Clinical properties of the short mood and feelings questionnaire: Development of a free calculator based on the Brazilian high-risk cohort study
Jobim, G. D. S., do Amaral, J. V., Pacheco, J. P. G., Gadelha, A., Miguel, E. C., Bressan, R. A., Pan, P. M., Rohde, L. A., Salum, G. A., & Hoffmann, M. S. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.08.025 · Cited by 2
Hierarchical neurocognitive model of externalizing and internalizing comorbidity
Xie, C., Xiang, S., Zheng, Y., Shen, C., Li, Y., Cheng, W., Vaidya, N., Zhang, Z., Robinson, L., Winterer, J. M., et al. (2026) · Nature Mental Health · doi:10.1038/s44220-025-00577-2 · Cited by 2
Investigating the shared factor structure of the GAD-7 and PHQ-9 in non-clinical samples of young adults
Gilbert, W., Tremblay, M.-J., Bureau, J. S., & Guay, F. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121456 · Cited by 2
Structural signature of plasma proteins classifies the status of Alzheimer’s disease
Son, A., Kim, H., Diedrich, J. K., Bamberger, C., Wilkins, H., Burns, J. M., Morris, J. K., Rissman, R. A., Swerdlow, R. H., & Yates, J. R. (2026) · Nature Aging · doi:10.1038/s43587-026-01078-2 · Cited by 4
“Interest in characterizing molecular profiles and pathway alterations related to NPSs and AD is continuing to grow 21 .”
Resilience Is Associated with Improved Emotion Regulation and Internalizing Symptoms Following Transdiagnostic Treatment in a Diverse Sample of Children
Chad-Friedman, S., Cummings, C. M., Shiffrin, N. D., Alvord, M. K., & Rich, B. A. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02424-9 · Cited by 2
“…similar cognitive, behavioral, and affective manifestations, and; 2) expanding the scope of treatment protocols to address more disorders can help reduce barriers to treatment implementation and dissemination by reducing the need for numerous disorder-specific treatments (Fusar‐Poli et al., 2019).”
Background
Rumination as a Transdiagnostic Notion
Sürü, D. (2023) · Türk Psikolojik Danışma ve Rehberlik Dergisi · doi:10.17066/tpdrd.1211657ds · Cited by 2
The philosophies of madness: an introduction
Feyaerts, J., & Sips, R. (2023) · Philosophical Psychology · doi:10.1080/09515089.2023.2258311 · Cited by 2
“, the categorial vs transdiagnostic nature of psychopathology (Fusar-Poli et al., 2019), or the currently popular appeal to “complaint-oriented” or “symptom-focused” approaches (Bentall, 2006).”
Background
Multimodal Markers of Transdiagnostic Childhood Mental Health Impairment
Cherian, J., Loftness, B. C., Cohen, J. G., Halvorson-Phelan, J., McGinnis, E. W., & McGinnis, R. S. (2024) · Wearable and Implantable Body Sensor Networks · doi:10.1109/bsn63547.2024.10780528 · Cited by 2
The uses and abuses of psychodiagnostic terms in family court cases: Beyond labels to the humanity beneath
Saposnek, D. T., & Berstein, D. (2025) · Family Court Review · doi:10.1111/fcre.12851 · Cited by 3
Transdiagnostic efficacy of lurasidone on depressive symptoms: systematic review and meta-analysis of randomised controlled trials
Ghenciulescu, A., Pearse, A., Minichino, A., Sampogna, G., Giorgi, R. D., & Fiorillo, A. (2025) · The British Journal of Psychiatry · doi:10.1192/bjp.2025.10343 · Cited by 2
“Therefore, we leverage a trans-diagnostic approach to this systematic review and pairwise meta-analysis, 7 aiming to assess the antidepressant effects of lurasidone by considering studies performed in populations with a variety of psychiatric diagnoses.”
Influential
Autism-ness Does Not Exist, but Autism Does. Part 1: A Critic of the “Spectrum” Position Used to Describe, Diagnose, and Research Autism, and Its Alternative
Mottron, L., McGuire, O. L., & Gagnon, D. (2025) · Autism & Developmental Language Impairments · doi:10.1177/23969415251404764 · Cited by 2
Is “Self-Experience” Really a Transdiagnostic Concept? Preliminary Evidence in Favor of the Transdiagnostic Conception of Functional Analytic Psychotherapy
Palma, A. M. G., Sánchez-Sánchez, L. C., & García‐Montes, J. M. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.671223 · Cited by 2
The EPIDIA4Kids protocol for a digital epidemiology study on brain functioning in children, based on a multimodality biometry tool running on an unmodified tablet
Douet, V., Marchand, T., Hennequin, A., Caci, H. M., & Staccini, P. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1185565 · Cited by 3
The Hierarchical Taxonomy of Psychopathology
Emery, L. T., Evans, C. M., Dimmick, A. A., & Simms, L. J. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-91497-0.00095-3 · Cited by 2
Editorial: Affective self-regulation and mental disorders: A transdiagnostic disposition in psychopathology
Hairston, I. S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1053988 · Cited by 2
Brief remote psychological treatments for healthcare workers with emotional distress during the SARS-CoV-2 pandemic: a randomized clinical trialPreprint
Salum, G. A., Costa, M. D. A., Spanemberg, L., Simioni, A., Gosmann, N. P., de Souza, L. H., Cuijpers, P. J., Pine, D. S., Brunoni, A. R., Kristensen, C. H., et al. (2024) · medRxiv · doi:10.1101/2024.09.04.24313084 · Cited by 2
Distinct neural alterations in schizophrenia and autism: A meta-analysis of social cognition and emotion processingPreprint
Boisvert, M., Pilon, F., Mottron, L., & Potvin, S. (2024) · medRxiv · doi:10.1101/2024.10.11.24315338 · Cited by 2
“Some have argued that the success of the ‘’transdiagnostic revolution’’ in psychiatry (18) may be limited to certain dimensions as anxiety and depression (19) and may spare the relatively autonomy between ASD and schizophrenia, supporting the psychosis-autism diametrical model (20).”
Background
Transdiagnostic Approaches
Ornelas, A. C., & Moreira, M. (2024) · Transdiagnostic Approaches in Cognitive Behavioral Therapy · doi:10.1007/978-3-031-63494-9_2 · Cited by 1
Clinical and epidemiological profile of patients with mental disorders in a specialized outpatient clinic and its role in the psychosocial care network
Camargos, G. S., Garcia, M. A. V. A., de Almeida, C. A., Lopes, A. M., Borghi, F. A., Filho, G. M. D. A., de Mattos, L. C., & Brandão, C. C. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1274192 · Cited by 2
Translation, Validity, and Reliability of Depression Literacy Questionnaire in Iranian Young Adults
Raiisi, F., Ebrahimi, M., Ghahvehchi-Hosseini, F., Jafari, K., & Rahmati-Najarkolaei, F. (2024) · International Journal of Preventive Medicine · doi:10.4103/ijpvm.ijpvm_311_23 · Cited by 1
Attentional Processing Biases in Young People With Binging and Purging Behavior
Freccero, A., Burmester, V., Rodrigues, R., Gallucci, A., Nicholls, D., & Simplicio, M. C. D. (2025) · Brain and Behavior · doi:10.1002/brb3.70322 · Cited by 2
Genetic and neurobiological mechanisms underlying transition in self-injury thoughts and behaviours during adolescence
Wen, X., Sun, Y., Wang, S., Yue, W., & Chen, R. (2025) · The British Journal of Psychiatry · doi:10.1192/bjp.2025.10300 · Cited by 1
Association between the autistic traits, internalising and externalising traits, dysregulation, and competence in 18-36-months toddlers
Levante, A., Martis, C., Duma, L., & Lecciso, F. (2025) · Research in Autism · doi:10.1016/j.reia.2025.202679 · Cited by 2
Medical costs and related factors associated with mental disorders in Jilin Province, China, 2020–2022
Yuan, J., Yin, Y., Yu, Y., Zhao, H., Gao, S. H., Ning, L., Xu, Y., Liu, H., Zhu, H., & Yu, X. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13259-7 · Cited by 1
Imagining Indigenized Futures: Multi-Eyed Seeing and Decolonialism in Integrative Health Equity
Qinaʻau, J., Chao, M. T., Seabury, A. A., & Antonio, M. C. K. (2025) · Global Advances in Integrative Medicine and Health · doi:10.1177/27536130251375057 · Cited by 1
“64 Participants predominantly articulated health challenges through the lens of stress and fatigue, transcending clinical diagnostic boundaries.”
Functional Network Connectivity Deviation Is Associated With Transdiagnostic Symptomatology: Brain Connectivity Links to Transdiagnostic Symptoms
Kist, J. D., Fraza, C., Savage, H. S., Mulders, P. C. R., Vrijsen, J. N., Collard, R. M., Tendolkar, I., van Eijndhoven, P., & Marquand, A. F. (2025) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2025.09.014 · Cited by 1
Early Intervention and Disorder-specific Group Cognitive Behavioral Therapy for Socially Anxious Adolescents
Velthuizen, S. L. M., Miers, A. C., van den Bos, E., Hagen, A., & Westenberg, P. M. (2025) · Journal of Child and Family Studies · doi:10.1007/s10826-025-03187-9 · Cited by 3
The Third Functional Brain Unit in a Shattered World: Revisiting Neuropsychological Dysfunctions Through the Lens of Luria and Vygotsky
Maouch, M. E., Shi, Y., Jin, Z., Abi‐Habib, R., & Zhou, Q. (2025) · Human Arenas · doi:10.1007/s42087-025-00538-2 · Cited by 1
Subtypes of adolescent major depressive disorder characterized by divergent information dynamics in sensory-association cortices
Liu, X., Wan, B., Wu, X., Zhang, X., Liu, L., Long, S., Ge, R., Cui, R., Wen, X., Liu, X., et al. (2026) · Nature Communications · doi:10.1038/s41467-026-69697-2 · Cited by 5
The contribution of emotion regulation in determining individuals’ profiles of positive mental health
Ruini, C., Vescovelli, F., Angelis, G. D., Marco, E. D., Castaldo, S., Cesarano, V. P., Marco, E. L. D., Polizzotto, G., Pingani, L., Limone, P., et al. (2026) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2026.101053 · Cited by 1
Extracting common processes across psychotherapies through AI
Vancappel, A., Serres, B., Bouyer, C., Saur, R., Fourel, E., Tapia, G., Kosinski, T., Carré, A., Bortolon, C., Marteau-Chasserieau, F., et al. (2026) · L Encéphale · doi:10.1016/j.encep.2026.01.003 · Cited by 2

Authors: Fusar‐Poli, P., Solmi, M., Brondino, N., Davies, C., Chae, C., Politi, P., Borgwardt, S., Lawrie, S. M., Parnas, J., & McGuire, P.
Affiliations: King's College London (GB)
University of Padua (IT)
University of Pavia (IT)
Pennsylvania State University (US)
University of Basel (CH)
University of Edinburgh (GB)
University of Copenhagen (DK)
ORCID: Fusar‐Poli, Paolo
Solmi, Marco
Brondino, Natascia
Davies, Cathy
Chae, Chungil
Politi, Pierluigi
Borgwardt, Stefan
Lawrie, Stephen M.
Parnas, Josef
McGuire, Philip
Venue: World Psychiatry
Publisher: Wiley
Published: 2019-05-06
Volume: 18
Issue: 2
Pages: 192-207
ISSN: 1723-8617 (ISSN-L)
2051-5545
DOI: 10.1002/wps.20631
PMC: PMC6502428
OpenAlex: W2944431228
Cited by: 409
References: 151
Citations by year: 2026: 59 · 2025: 70 · 2024: 48 · 2023: 52 · 2022: 52 · 2021: 67 · 2020: 40 · 2019: 20
FWCI: 6.68
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: World Psychiatry (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
Research Portal (King's College London) (submittedVersion, other-oa)
Padua Research Archive (University of Padova) (submittedVersion)
Funders: King's College London
Medical Research Council (MC_PC_16048)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: transdiagnostic psychiatry, psychiatric classification, DSM, ICD, mental illness, transdiagnostic features, anxiety disorders, depressive disorders, transdiagnostic treatment, research quality, research recommendations

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Transdiagnostic psychiatry: a systematic review

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