The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.
Clinical Staging of Psychiatric Disorders: A Heuristic Framework for Choosing Earlier, Safer and more Effective Interventions
Open accessAbstract
Diagnosis in psychiatry increasingly struggles to fulfil its key purposes, namely, to guide treatment and to predict outcome. The clinical staging model, widely used in clinical medicine yet virtually ignored in psychiatry, is proposed as a more refined form of diagnosis which could restore the utility of diagnosis, promote early intervention and also make more sense of the confusing array of biological research findings in psychiatry by organizing data into a coherent clinicopathological framework. A selective review of key papers in clinical medicine and psychiatry which describe clinical and clinicopathological staging, and a range of related issues. Clinical staging has immediate potential to improve the logic and timing of interventions in psychiatry just as it does in many complex and potentially serious medical disorders. Interventions could be evaluated in terms of their ability to prevent or delay progression from earlier to later stages of disorder, and they could be selected on clear-cut risk/benefit criteria. Biological variables and a range of candidate risk factors could be studied within and across stages, and their role, specificity and centrality in risk, onset and progression of disorder could be greatly clarified. A clinicopathological framework could be progressively constructed. Clinical staging with a restructure across and within diagnostic boundaries with the explicit operationalization of criteria for extent and progression of disorder should be actively explored in psychiatry as a heuristic strategy for the development and evaluation of earlier, safer, and more effective clinical interventions, and for clarifying the biological basis of psychiatric disorders.
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“Clinical staging 197,200-203 is one such emerging heuristic framework, which allows the boundary between health and illness to be defined and managed such that interventions can be proportional to need and overdiagnosis, overtreatment, and undertreatment can be minimised. 200,202-205”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [203]
In the citing paper
“staging frameworks hold the promise of guiding treatment selection, with less intensive interventions preferred at earlier stages and interventions with a higher risk/benefit ratio reserved for later stages [89]”
From Towards a youth mental health paradigm: a perspective and roadmap (2023) · cites this paper as [89]
In the citing paper
“The clinical staging model for psychosis is the most established 54,55 , but similar models also emerged for bipolar 56-59 , depressive 60,61 and anxiety 62-65 disorders.”
From Preventive psychiatry: a blueprint for improving the mental health of young people (2021) · cites this paper as [54]
In the citing paper
“Great efforts are been made in some exceptional settings to identify and treat markers of deviant development or early symptoms with the hope that this will prevent major disorders to appear or reduce associated disability.63”
From Developmental Differences Between Schizophrenia and Bipolar Disorder (2017) · cites this paper as [63]
In the citing paper
“In the same vein as single risk genes have pleiotropic effects leading to diverse outcomes and similar outcomes can be associated with different risk genes, individual developmental markers can have pluripotencial outcomes and same outcome can have different pathways that lead to it.62,63”
From Developmental Differences Between Schizophrenia and Bipolar Disorder (2017) · cites this paper as [63]
Citations
Cites
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Self-citationAustralian and New Zealand Journal of Psychiatry
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Untreated Depression and Hippocampal Volume Loss
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Recovery from psychotic illness: A 15- and 25-year international follow-up study
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Clinical Epidemiology - a basic science for clinical medicine
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Clinical and Investigative Medicine
Silverman, M. P., Siminovitch, K. A., McGugan, S., Bergeron, M. G., Cook, D. J., Eaves, A. C., Grover, S. A., Stanbrook, M. B., & Finnigan, A. (2006) · Cited by 568
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Berk, M., Kapczinski, F., Andreazza, A. C., Dean, O. M., Giorlando, F., Maes, M., Yücel, M., Gama, C. S., Dodd, S., Dean, B., et al. (2011) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2010.10.001 · Cited by 1,178
Self-citationAmminger, G. P., Schäfer, M. R., Papageorgiou, K., Klier, C. M., Cotton, S. M., Harrigan, S. M., Mackinnon, A., McGorry, P. D., & Berger, G. E. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.192 · Cited by 896
Self-citationGalletly, C., Castle, D., Dark, F., Humberstone, V., Jablensky, A., Killackey, E., Kulkarni, J., McGorry, P., Nielssen, O., & Tran, N. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416641195 · Cited by 877
Self-citationA meta-analysis of cognitive deficits in first-episode Major Depressive Disorder
Lee, R. S. C., Hermens, D. F., Porter, M. A., & Redoblado-Hodge, M. A. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.10.023 · Cited by 737
The Lancet Psychiatry Commission on youth mental health
McGorry, P. D., Mei, C., Dalal, N., Alvarez-Jimenez, M., Blakemore, S.-J., Browne, V., Dooley, B., Hickie, I. B., Jones, P. B., McDaid, D., et al. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00163-9 · Cited by 663
Self-citation
Metadata
- Authors
- McGorry, P. D., Hickie, I. B., Yung, A. R., Pantelis, C., & Jackson, H. J.
- Affiliations
- The University of Melbourne (AU)
- The University of Sydney (AU)
- The Royal Melbourne Hospital (AU)
- Corresponding author
- McGorry, Patrick D.
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2006-08
- Volume
- 40
- Issue
- 8
- Pages
- 616-622
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W2132476041
- Cited by
- 919
- References
- 41
- Citations by year
- 2026: 43 · 2025: 50 · 2024: 48 · 2023: 43 · 2022: 53 · 2021: 54 · 2020: 50 · 2019: 71 · 2018: 48 · 2017: 46 · 2016: 38 · 2015: 52 · 2014: 43 · 2013: 52 · 2012: 54
- FWCI
- 210.06
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Health and Medical Research Council
- National Medical Research Council
- Topics
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- clinical staging, psychiatric diagnosis, early intervention, clinicopathological staging, disease progression, risk factors, biomarkers, treatment selection, heuristic framework, mental illness
- MeSH terms
- Mental Disorders, Combined Modality Therapy, Humans, Mental Health Services, Prognosis, Comorbidity, Treatment Outcome, Disease Progression
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