Clinical Staging for Youth Mental Disorders: Progress in Reforming Diagnosis and Clinical Care
Abstract
Current silo-based diagnostic systems for mental disorders lack utility and fail to fulfil a fundamental purpose of diagnosis: to guide treatment planning and predict outcomes. Diagnostic reform has gained momentum, and clinical staging has emerged as a promising framework to improve the precision of diagnosis, particularly in early illness stages, and fill current gaps in linking diagnosis to more personalized and effective intervention, prognosis, and neurobiological markers. Transdiagnostic clinical staging recognizes that the early development of mental ill-health is marked by substantial fluidity and that symptoms may, although not inevitably, evolve into more stable diagnosable syndromes. Staging facilitates the selection of interventions that are proportionate to the current need and risk of illness progression and provides an efficient framework to organize biomarker data and guide service delivery. Here, we provide an overview of transdiagnostic clinical staging and summarize key evidence supporting its ability to integrate biomarkers and guide mental health care.
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Staged care has been introduced as an alternative to stepped care.
“Staged care has been introduced as an alternative to stepped care [34].”
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Clinical classification in mental health at the cross-roads: which direction next?
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Bioactive lipids in schizophrenia
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Self-citationCircadian profiles in young people during the early stages of affective disorder
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Increased oxidative stress and oxidative DNA damage in non-remission schizophrenia patients
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Treatment patterns and short‐term outcomes in an early intervention youth mental health service
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Clinical Staging in Psychiatry
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Validation of the InnoWell Platform: Protocol for a Clinical Trial
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Clinical high risk and first episode schizophrenia: Auditory event-related potentials
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Self-citationPolyunsaturated fatty acid associations with dopaminergic indices in major depressive disorder
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Self-citationThe role of technology in Australian youth mental health reform
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Putative neuroprotective pharmacotherapies to target the staged progression of mental illness
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The next stage for diagnosis: validity through utility
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Self-citationFrontal lobe changes occur early in the course of affective disorders in young people
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Microstructural white matter changes are correlated with the stage of psychiatric illness
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Self-citationPhospholipase A2 activity is associated with structural brain changes in schizophrenia
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Beyond diagnosis in psychiatric practice
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Albert C. Broders' Paradigm Shifts Involving the Prognostication and Definition of Cancer
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Self-citationClassification of psychopathology: conceptual and historical background
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Erythrocyte glutathione levels as long-term predictor of transition to psychosis
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Self-citationTreatment of social anxiety disorder and attenuated psychotic symptoms with cannabidiol
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Relationship Between Polyunsaturated Fatty Acids and Psychopathology in the NEURAPRO Clinical Trial
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Neurocognitive deficits in a transdiagnostic clinical staging model
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Novel biotherapies are needed in youth mental health
Amminger, G. P., Berger, M., Rice, S., Davey, C. G., Schäfer, M. R., & McGorry, P. D. (2017) · Australasian Psychiatry · doi:10.1177/1039856217698237 · Cited by 20 · see citing works
Self-citationClinical staging for youth at‐risk for serious mental illness: A longitudinal perspective
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Aberrant limbic brain structures in young individuals at risk for mental illness
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Sleep disturbances in youth at‐risk for serious mental illness
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Neuroinflammation and Schizophrenia
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Time to stop flogging a dead horse?
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White Matter Connectivity in Youth at Risk for Serious Mental Illness: A Longitudinal Analysis
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White Matter Integrity According to the Stage of Mental Disorder in Youth
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Staging of Cognition in Psychiatric Illness
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Bartholomeusz, C. F., & Pantelis, C. (2019) · Cambridge University Press eBooks · doi:10.1017/9781139839518.006 · Cited by 1 · see citing works
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The Lancet Psychiatry Commission on youth mental health
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Self-citationTreatment of Posttraumatic Stress Disorder: A State-of-the-art Review
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A review of approaches and models in psychopathology conceptualization research
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Self-citationEarly intervention for personality disorder
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Toward staging differentiation for posttraumatic stress disorder treatment
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Hutsebaut, J., Clarke, S. L., & Chanen, A. M. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1130417 · Cited by 36 · see citing works
“For this reason, the notion of ‘staged care’ was introduced (72), which involves matching of care to the clinical stage of illness and needs of the young person.”
BackgroundDestrée, L., McGorry, P. D., Chanen, A. M., Ratheesh, A., Davey, C. G., Polari, A. R., Amminger, G. P., Yuen, H. P., Hartmann, J., Dwyer, D., et al. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2024.115745 · Cited by 22 · see citing works
Self-citationUnderstanding divergence: Placing developmental neuroscience in its dynamic context
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Challenges and Solutions to the Measurement of Neurocognitive Mechanisms in Developmental Settings
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Havers, L., von Stumm, S., Cardno, A. G., Freeman, D. H., & Ronald, A. (2022) · Psychological Medicine · doi:10.1017/s0033291722002914 · Cited by 9 · see citing works
McKenna, S., Hutcheon, A., Gorban, C., Song, Y. J. C., Scott, E. M., & Hickie, I. B. (2024) · Health Expectations · doi:10.1111/hex.14137 · Cited by 7 · see citing works
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Clinical Staging for Psychiatry and Psychology
Dwyer, D., Ye, R. R., Nelson, B., & McGorry, P. D. (2025) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-081423-025310 · Cited by 5 · see citing works
Self-citationApplication to Children and Young People
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“Staged care has been introduced as an alternative to stepped care [34].”
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Capturing developmental dynamics within a transdiagnostic framework: Challenges and promisesPreprint
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Transdiagnostic stage-based monitoring of public mental health
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Early Intervention Across Mental Health Services
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Defining Recovery and Relapse in Bulimia Nervosa: A Systematic Review of the Literature
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Common Substrates of Early Illness Severity: Clinical, Genetic, and Brain EvidencePreprint
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- Authors
- McGorry, P. D., & Mei, C.
- Affiliations
- The University of Melbourne (AU)
- Venue
- Annual Review of Developmental Psychology
- Publisher
- Annual Reviews
- Published
- 2021-12-09
- Volume
- 3
- Issue
- 1
- Pages
- 15-39
- ISSN
- 2640-7922 (ISSN-L)
- OpenAlex
- W3185569264
- Cited by
- 38
- References
- 154
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 9 · 2023: 8 · 2022: 4
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annual Review of Developmental Psychology (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- clinical staging, adolescent mental disorders, biomarkers, personalized interventions, prognosis, disease progression, service delivery, developmental psychopathology
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