Diagnosis without Borders: A Pluripotential Approach to Preventive Intervention in Emerging Mental Disorders

Poster A22, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron

Patrick McGorry1; 1Orygen, The National Centre of Excellence in Youth Mental Health

The clinical staging model in psychiatry recognizes that mental disorders are not static, sharply defined illnesses with separate aetiologies and courses, but rather syndromes that overlap and develop in stages. This model posits that mental illness evolves from an initial pluripotential risk state, through a series of stages in which symptoms and distress intensify, accompanied by progressive neurobiological changes, until a discrete mental disorder appears. Within this model, transition from one stage of illness to the next is not inevitable; a number of trajectories are possible, including remission, recovery, as well as progression of illness. This model has wide-ranging implications for clinical practice, as well as our understanding of the fundamental basis of mental illness. We argue that the current categorical diagnostic systems have limited clinical utility, and questionable validity given the significant overlap in the symptomatology, neurobiology and genetics of the major mental illnesses. In contrast, a clinical staging model proposes a transdiagnostic approach to therapeutic intervention that enables a pre-emptive focus to treatment, based on risk-benefit considerations and adapted to the individual’s clinical profile at the time. It also offers a framework for integrating our burgeoning knowledge of the basic social, environmental and biological mechanisms driving mental illness, and around which a truly personalized, pre-emptive psychiatry can be developed. This symposium will explore how clinical staging can be used to guide treatment, and it's utility for understanding (if not predicting) treatment outcomes and prognosis in young people seeking help for mental health problems.

Topic Area: Diagnosis and Phenomenology

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