Skip to main content
SpringerLink
Log in

Early Identification of Psychiatric Disorders

  • Chapter
  • First Online:
Frontiers in Psychiatry

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1192))

Abstract

Early detection and early intervention approach targets people at-risk stages who are very close to conversion to illness, or patients who have just transited the illness stage and have not, yet, become chronic. Rigorous efforts have been put in for early detection and early intervention in psychiatry. A high-risk population is identified by clinical manifestations that, as per their severity and suffering, do not yet meet the diagnostic criteria of psychiatric disorders. There have been attempts to break through the existing phenotype-based diagnostic system using biomarkers, but researchers have yet to overcome the heterogeneity of the disease. Nowadays, the clinical staging models in psychosis, bipolar, and depressive disorders have been proposed as a heuristic and a practical alternative to this. This model is evolving to integrate various demographic factors, clinical symptoms, cognitive functions, and biomarkers.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lopez AD, Murray CC. The global burden of disease, 1990–2020. Nat Med. 1998;4(11):1241–3.

    Article  CAS  PubMed  Google Scholar 

  2. Collins PY, Patel V, Joestl SS, March D, Insel TR, Daar AS, et al. Grand challenges in global mental health. Nature. 2011;475(7354):27–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. McGorry PD, Killackey E, Yung A. Early intervention in psychosis: concepts, evidence and future directions. World Psychiatry Off J World Psychiatr Assoc WPA. 2008;7(3):148–56.

    Google Scholar 

  4. McGlashan TH, Zipursky RB, Perkins D, Addington J, Miller TJ, Woods SW, et al. The PRIME North America randomized double-blind clinical trial of olanzapine versus placebo in patients at risk of being prodromally symptomatic for psychosis. I. Study rationale and design. Schizophr Res. 2003;61(1):7–18.

    Article  CAS  PubMed  Google Scholar 

  5. Marshall M, Lewis S, Lockwood A, Drake R, Jones P, Croudace T. Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Arch Gen Psychiatry. 2005;62(9):975–83.

    Article  PubMed  Google Scholar 

  6. Perkins DO, Gu H, Boteva K, Lieberman JA. Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis. Am J Psychiatry. 2005;162(10):1785–804.

    Article  PubMed  Google Scholar 

  7. Fusar-Poli P, Borgwardt S, Bechdolf A, Addington J, Riecher-Rössler A, Schultze-Lutter F, et al. The psychosis high-risk state: a comprehensive state-of-the-art review. JAMA Psychiatry. 2013;70(1):107–20.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Häfner H, Maurer K. Early detection of schizophrenia: current evidence and future perspectives. World Psychiatry. 2006;5(3):130–8.

    PubMed  PubMed Central  Google Scholar 

  9. Yung AR, Yuen HP, McGorry PD, Phillips LJ, Kelly D, Dell’Olio M, et al. Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Aust N Z J Psychiatry. 2005;39(11–12):964–71.

    Article  PubMed  Google Scholar 

  10. Fusar-Poli P, Bonoldi I, Yung AR, Borgwardt S, Kempton MJ, Valmaggia L, et al. Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry. 2012;69(3):220–9.

    Article  PubMed  Google Scholar 

  11. Mittal VA, Dean DJ, Mittal J, Saks ER. Ethical, legal, and clinical considerations when disclosing a high-risk syndrome for psychosis. Bioethics. 2015;29(8):543–56.

    Article  PubMed  Google Scholar 

  12. Addington J, Cornblatt BA, Cadenhead KS, Cannon TD, McGlashan TH, Perkins DO, et al. At clinical high risk for psychosis: outcome for nonconverters. Am J Psychiatry. 2011;168(8):800–5.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Yung AR, Yuen HP, Berger G, Francey S, Hung T-C, Nelson B, et al. Declining transition rate in ultra high risk (prodromal) services: dilution or reduction of risk? Schizophr Bull. 2007;33(3):673–81.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Fusar-Poli P, Schultze-Lutter F, Cappucciati M, Rutigliano G, Bonoldi I, Stahl D, et al. The dark side of the moon: meta-analytical impact of recruitment strategies on risk enrichment in the clinical high risk state for psychosis. Schizophr Bull. 2016;42(3):732–43.

    Article  PubMed  Google Scholar 

  15. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RMA, Petukhova M, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007;64(5):543–52.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Skjelstad DV, Malt UF, Holte A. Symptoms and signs of the initial prodrome of bipolar disorder: a systematic review. J Affect Disord. 2010;126(1–2):1–13.

    Article  PubMed  Google Scholar 

  17. Correll CU, Penzner JB, Frederickson AM, Richter JJ, Auther AM, Smith CW, et al. Differentiation in the preonset phases of schizophrenia and mood disorders: evidence in support of a bipolar mania prodrome. Schizophr Bull. 2007;33(3):703–14.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Noto MN, de Souza Noto C, de Jesus DR, Zugman A, Mansur RB, Berberian AA, et al. Recognition of bipolar disorder type I before the first manic episode: challenges and developments. Expert Rev Neurother. 2013;13(7):795–806; quiz 807.

    Article  CAS  PubMed  Google Scholar 

  19. Bechdolf A, Nelson B, Cotton SM, Chanen A, Thompson A, Kettle J, et al. A preliminary evaluation of the validity of at-risk criteria for bipolar disorders in help-seeking adolescents and young adults. J Affect Disord. 2010;127(1–3):316–20.

    Article  PubMed  Google Scholar 

  20. Bechdolf A, Ratheesh A, Cotton SM, Nelson B, Chanen AM, Betts J, et al. The predictive validity of bipolar at-risk (prodromal) criteria in help-seeking adolescents and young adults: a prospective study. Bipolar Disord. 2014;16(5):493–504.

    Article  PubMed  Google Scholar 

  21. Fusar-Poli P, De Micheli A, Rocchetti M, Cappucciati M, Ramella-Cravaro V, Rutigliano G, et al. Semistructured interview for bipolar at risk states (SIBARS). Psychiatry Res. 2018;264:302–9.

    Article  PubMed  Google Scholar 

  22. Van Meter A, Guinart D, Bashir A, Sareen A, Cornblatt BA, Auther A, et al. Bipolar prodrome symptom scale—abbreviated screen for patients: description and validation. J Affect Disord. 2019;15(249):357–65.

    Article  Google Scholar 

  23. Hafeman DM, Merranko J, Axelson D, Goldstein BI, Goldstein T, Monk K, et al. Toward the definition of a bipolar prodrome: dimensional predictors of bipolar spectrum disorders in at-risk youths. Am J Psychiatry. 2016;173(7):695–704.

    Article  PubMed  Google Scholar 

  24. Lewinsohn PM, Rohde P, Seeley JR. Major depressive disorder in older adolescents: prevalence, risk factors, and clinical implications. Clin Psychol Rev. 1998;18(7):765–94.

    Article  CAS  PubMed  Google Scholar 

  25. Hetrick SE, Parker AG, Hickie IB, Purcell R, Yung AR, McGorry PD. Early identification and intervention in depressive disorders: towards a clinical staging model. Psychother Psychosom. 2008;77(5):263–70.

    Article  CAS  PubMed  Google Scholar 

  26. Lee DTS, Chung TKH. Postnatal depression: an update. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):183–91.

    Article  PubMed  Google Scholar 

  27. Swainson R, Hodges JR, Galton CJ, Semple J, Michael A, Dunn BD, et al. Early detection and differential diagnosis of Alzheimer’s disease and depression with neuropsychological tasks. Dement Geriatr Cogn Disord. 2001;12(4):265–80.

    Article  CAS  PubMed  Google Scholar 

  28. Agius M, Zaman R, Hanafy D. An audit to assess the consequences of the use of a pluripotential risk syndrome: the case to move on from “psychosis risk syndrome (PRS)”. Psychiatr Danub. 2013;25(Suppl 2):S282–5.

    PubMed  Google Scholar 

  29. Woods SW, Powers AR, Taylor JH, Davidson CA, Johannesen JK, Addington J, et al. Lack of diagnostic pluripotentiality in patients at clinical high risk for psychosis: specificity of comorbidity persistence and search for pluripotential subgroups. Schizophr Bull. 2018;44(2):254–63.

    Article  PubMed Central  Google Scholar 

  30. Fusar-Poli P, Nelson B, Valmaggia L, Yung AR, McGuire PK. Comorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: impact on psychopathology and transition to psychosis. Schizophr Bull. 2014;40(1):120–31.

    Article  PubMed  Google Scholar 

  31. Lee TY, Lee J, Kim M, Choe E, Kwon JS. 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(2):276–85.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hartmann JA, Nelson B, Spooner R, Paul Amminger G, Chanen A, Davey CG, et al. Broad clinical high-risk mental state (CHARMS): methodology of a cohort study validating criteria for pluripotent risk. Early Interv Psychiatry. 2017.

    Google Scholar 

  33. McGorry PD. Beyond psychosis risk: early clinical phenotypes in mental disorder and the subthreshold pathway to safe, timely and effective care. Psychopathology. 2014;47(5):285–6.

    Article  PubMed  Google Scholar 

  34. McGorry P. Early clinical phenotypes and risk for serious mental disorders in young people: need for care precedes traditional diagnoses in mood and psychotic disorders. Can J Psychiatry Rev Can Psychiatr. 2013;58(1):19–21.

    Article  Google Scholar 

  35. Howes OD, Bose SK, Turkheimer F, Valli I, Egerton A, Valmaggia LR, et al. Dopamine synthesis capacity before onset of psychosis: a prospective [18F]-DOPA PET imaging study. Am J Psychiatry. 2011;168(12):1311–7.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Allen P, Luigjes J, Howes OD, Egerton A, Hirao K, Valli I, et al. Transition to psychosis associated with prefrontal and subcortical dysfunction in ultra high-risk individuals. Schizophr Bull. 2012;38(6):1268–76.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Howes OD, Shotbolt P, Bloomfield M, Daalman K, Demjaha A, Diederen KMJ, et al. Dopaminergic function in the psychosis spectrum: an [18F]-DOPA imaging study in healthy individuals with auditory hallucinations. Schizophr Bull. 2013;39(4):807–14.

    Article  PubMed  Google Scholar 

  38. Demjaha A, Murray RM, McGuire PK, Kapur S, Howes OD. Dopamine synthesis capacity in patients with treatment-resistant schizophrenia. Am J Psychiatry. 2012;169(11):1203–10.

    Article  PubMed  Google Scholar 

  39. Jauhar S, Nour MM, Veronese M, Rogdaki M, Bonoldi I, Azis M, et al. A Test of the transdiagnostic dopamine hypothesis of psychosis using positron emission tomographic imaging in bipolar affective disorder and schizophrenia. JAMA Psychiatry. 2017;74(12):1206–13.

    Article  PubMed  PubMed Central  Google Scholar 

  40. McGorry PD, Purcell R, Hickie IB, Yung AR, Pantelis C, Jackson HJ. Clinical staging: a heuristic model for psychiatry and youth mental health. Med J Aust. 2007;187(7 Suppl):S40–2.

    PubMed  Google Scholar 

  41. Scott J, Leboyer M, Hickie I, Berk M, Kapczinski F, Frank E, et al. Clinical staging in psychiatry: a cross-cutting model of diagnosis with heuristic and practical value. Br J Psychiatry. 2013;202(4):243–5.

    Article  PubMed  Google Scholar 

  42. McGorry PD, Hickie IB, Yung AR, Pantelis C, Jackson HJ. Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry. 2006;40(8):616–22.

    Article  PubMed  Google Scholar 

  43. Tsuang MT, Van Os J, Tandon R, Barch DM, Bustillo J, Gaebel W, et al. Attenuated psychosis syndrome in DSM-5. Schizophr Res. 2013;150(1):31–5.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Fava GA, Kellner R. Staging: a neglected dimension in psychiatric classification. Acta Psychiatr Scand. 1993;87(4):225–30.

    Article  CAS  PubMed  Google Scholar 

  45. Lieberman JA, Perkins D, Belger A, Chakos M, Jarskog F, Boteva K, et al. The early stages of schizophrenia: speculations on pathogenesis, pathophysiology, and therapeutic approaches. Biol Psychiatry. 2001;50(11):884–97.

    Article  CAS  PubMed  Google Scholar 

  46. McGorry PD, Nelson B, Goldstone S, Yung AR. Clinical staging: a heuristic and practical strategy for new research and better health and social outcomes for psychotic and related mood disorders. Can J Psychiatry. 2010;55(8):486–97.

    Article  PubMed  Google Scholar 

  47. McGorry P, Keshavan M, Goldstone S, Amminger P, Allott K, Berk M, et al. Biomarkers and clinical staging in psychiatry. World Psychiatry. 2014;13(3):211–23.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Addington J, Liu L, Goldstein BI, Wang J, Kennedy SH, Bray S, et al. Clinical staging for youth at-risk for serious mental illness. Early Interv Psychiatry. 2019.

    Google Scholar 

  49. Berendsen S, van der Paardt J, van Bruggen M, Nusselder H, Jalink M, Peen J, et al. Exploring construct validity of clinical staging in schizophrenia spectrum disorders in an acute psychiatric ward. Clin Schizophr Relat Psychoses. 2018.

    Google Scholar 

  50. Godin O, Fond G, Bulzacka E, Schurhoff F, Boyer L, Myrtille A, et al. Validation and refinement of the clinical staging model in a French cohort of outpatient with schizophrenia (FACE-SZ). Prog Neuropsychopharmacol Biol Psychiatry. 2019;10(92):226–34.

    Article  Google Scholar 

  51. Berk M, Hallam KT, McGorry PD. The potential utility of a staging model as a course specifier: a bipolar disorder perspective. J Affect Disord. 2007;100(1–3):279–81.

    Article  PubMed  Google Scholar 

  52. Faedda GL, Baldessarini RJ, Glovinsky IP, Austin NB. Pediatric bipolar disorder: phenomenology and course of illness. Bipolar Disord. 2004;6(4):305–13.

    Article  PubMed  Google Scholar 

  53. Vieta E, Salagre E, Grande I, Carvalho AF, Fernandes BS, Berk M, et al. Early intervention in bipolar disorder. Am J Psychiatry. 2018;175(5):411–26.

    Article  PubMed  Google Scholar 

  54. Cosci F, Fava GA. Staging of mental disorders: systematic review. Psychother Psychosom. 2013;82(1):20–34.

    Article  PubMed  Google Scholar 

  55. McGorry PD, Hartmann JA, Spooner R, Nelson B. Beyond the “at risk mental state” concept: transitioning to transdiagnostic psychiatry. World Psychiatry Off J World Psychiatr Assoc WPA. 2018;17(2):133–42.

    Google Scholar 

  56. Hartmann JA, Nelson B, Ratheesh A, Treen D, McGorry PD. At-risk studies and clinical antecedents of psychosis, bipolar disorder and depression: a scoping review in the context of clinical staging. Psychol Med. 2019;49(2):177–89.

    Article  PubMed  Google Scholar 

  57. Raouna A, Osam CS, MacBeth A. Clinical staging model in offspring of parents with bipolar disorder: a systematic review. Bipolar Disord. 2018;20(4):313–33.

    Article  PubMed  Google Scholar 

  58. Fusar-Poli P, Solmi M, Brondino N, Davies C, Chae C, Politi P, et al. Transdiagnostic psychiatry: a systematic review. World Psychiatry Off J World Psychiatr Assoc WPA. 2019;18(2):192–207.

    Google Scholar 

  59. Fusar-Poli P, Oliver D, Spada G, Patel R, Stewart R, Dobson R, et al. Real world implementation of a transdiagnostic risk calculator for the automatic detection of individuals at risk of psychosis in clinical routine: study protocol. Front Psychiatry. 2019;10:109.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Fusar-Poli P, Werbeloff N, Rutigliano G, Oliver D, Davies C, Stahl D, et al. Transdiagnostic risk calculator for the automatic detection of individuals at risk and the prediction of psychosis: second replication in an independent national health service trust. Schizophr Bull. 2018.

    Google Scholar 

  61. Fusar-Poli P, Rutigliano G, Stahl D, Davies C, Bonoldi I, Reilly T, et al. Development and validation of a clinically based risk calculator for the transdiagnostic prediction of psychosis. JAMA Psychiatry. 2017;74(5):493–500.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Ratheesh A, Cotton SM, Betts JK, Chanen A, Nelson B, Davey CG, et al. Prospective progression from high-prevalence disorders to bipolar disorder: exploring characteristics of pre-illness stages. J Affect Disord. 2015;1(183):45–8.

    Article  Google Scholar 

Download references

Acknowledgements

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (Grant no. 2019R1A2B5B03100844).

Author information

Authors and Affiliations

  1. Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03035, Republic of Korea

    Tae Young Lee, Minah Kim & Jun Soo Kwon

Authors
  1. Tae Young Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Minah Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jun Soo Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jun Soo Kwon .

Editor information

Editors and Affiliations

  1. College of Medicine, Korea University, Seoul, Gyeonggi-do, Korea (Republic of)

    Yong-Ku Kim

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lee, T.Y., Kim, M., Kwon, J.S. (2019). Early Identification of Psychiatric Disorders. In: Kim, YK. (eds) Frontiers in Psychiatry. Advances in Experimental Medicine and Biology, vol 1192. Springer, Singapore. https://doi.org/10.1007/978-981-32-9721-0_18

Download citation

Publish with us

Policies and ethics

Search

Navigation