Early expressions of psychopathology and risk associated with trans-diagnostic transition to mood and psychotic disorders in adolescents and young adults
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Objectives: The heterogeneity and comorbidity of major mental disorders presenting in adolescents and young adults has fostered calls for trans-diagnostic research. This study examines early expressions of psychopathology and risk and trans-diagnostic caseness in a community cohort of twins and non-twin siblings. Methods: Using data from the Brisbane Longitudinal Twin Study, we estimated median number of self-rated psychiatric symptoms, prevalence of subthreshold syndromes, family history of mood and/or psychotic disorders, and likelihood of subsequent trans-diagnostic caseness (individuals meeting diagnostic criteria for mood and/or psychotic syndromes). Next, we used cross-validated Chi-Square Automatic Interaction Detector (CHAID) analyses to identify the nature and relative importance of individual self-rated symptoms that predicted trans-diagnostic caseness. We examined the positive and negative predictive values (PPV; NPV) and accuracy of all classifications (Area under the Curve and 95% confidence intervals: AUC; 95% CI). Results: Of 1815 participants (Female 1050, 58%; mean age 26.40), more than one in four met caseness criteria for a mood and/or psychotic disorder. Examination of individual factors indicated that the AUC was highest for subthreshold syndromes, followed by family history then self-rated psychiatric symptoms, and that NPV always exceeded PPV for caseness. In contrast, the CHAID analysis (adjusted for age, sex, twin status) generated a classification tree comprising six trans-diagnostic symptoms. Whilst the contribution of two symptoms (need for sleep; physical activity) to the model was more difficult to interpret, CHAID analysis indicated that four self-rated symptoms (sadness; feeling overwhelmed; impaired concentration; paranoia) offered the best discrimination between cases and non-cases. These four symptoms showed different associations with family history status. Conclusions: The findings need replication in independent cohorts. However, the use of CHAID might provide a means of identifying specific subsets of trans-diagnostic symptoms representing clinical phenotypes that predict transition to caseness in individuals at risk of onset of major mental disorders.
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Earliest expressions of psychopathology have high rates of co-occurrence, change from one clinical picture to another, and only gradually differentiate into more distinct mental disorders.
“These earliest expressions of psychopathology have high rates of co-occurrence, change from one clinical picture to another, and only gradually differentiate into more distinct mental disorders [67, 69, 70].”
From Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial (2024) · cites this paper as [70]
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Psikolojik Sağlamlığın Sınav Kaygısı Üzerindeki Etkisinde Anne Baba Tutumunun Aracılık Rolü
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- Authors
- Scott, J., Crouse, J. J., Ho, N., Iorfino, F., Martin, N., Parker, R., McGrath, J., Gillespie, N. A., Medland, S., & Hickie, I. B.
- Affiliations
- The University of Sydney (AU)
- QIMR Berghofer Medical Research Institute (AU)
- Virginia Commonwealth University (US)
- The University of Queensland (AU)
- Corresponding author
- Scott, Jan
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2021-06-04
- Volume
- 16
- Issue
- 6
- Pages
- e0252550
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC8177455
- OpenAlex
- W3164910755
- Cited by
- 15
- References
- 43
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 2
- FWCI
- 2.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Health and Medical Research Council (1031119, 1049911, APP10499110)
- National Health and Medical Research Council, Centre of Research Excellence (1061043)
- National Institute of Health (K99R00, R00DA02354)
- Australia Fellowship (511921)
- John Cade Fellowship (APP1056929)
- Niels Bohr Professorship, Danish National Research Foundation
- NHRMC fellowships (APP1103623 and APP1172917)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- mood disorders, psychosis, adolescents and young adults, family history of mental illness, early risk prediction, paranoia, sadness, impaired concentration, physical activity, twins and siblings
- MeSH terms
- Adolescent, Adult, Female, Humans, Male, Neuropsychological Tests, Psychotic Disorders, Twins, Mood Disorders, Early Diagnosis
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