Biomarkers and clinical staging in psychiatry

McGorry,P, Keshavan,M, Goldstone,S, Amminger,P, Allott,K, Berk,M, Lavoie,S, Pantelis,C, Yung,A, Wood,S and Hickie,I 2014, Biomarkers and clinical staging in psychiatry, World psychiatry, vol. 13, no. 3, pp. 211-223, doi: 10.1002/wps.20144.

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Title Biomarkers and clinical staging in psychiatry
Author(s) McGorry,P
Keshavan,M
Goldstone,S
Amminger,P
Allott,K
Berk,MORCID iD for Berk,M orcid.org/0000-0002-5554-6946
Lavoie,S
Pantelis,C
Yung,A
Wood,S
Hickie,I
Journal name World psychiatry
Volume number 13
Issue number 3
Start page 211
End page 223
Publisher John Wiley & Sons
Place of publication Oxford, England
Publication date 2014-10
ISSN 1723-8617
2051-5545
Keyword(s) Biomarkers
clinical staging
diagnostic reform
early intervention
personalized medicine
pre-emptive psychiatry
youth mental health
Science & Technology
Life Sciences & Biomedicine
Psychiatry
MAJOR DEPRESSIVE DISORDER
ULTRA-HIGH-RISK
PLACEBO-CONTROLLED-TRIAL
POLYUNSATURATED FATTY-ACIDS
PROGRESSIVE BRAIN CHANGES
PITUITARY-ADRENAL AXIS
OF-THE-LITERATURE
SLOW-WAVE SLEEP
BIPOLAR DISORDER
MISMATCH NEGATIVITY
Summary Personalized medicine is rapidly becoming a reality in today's physical medicine. However, as yet this is largely an aspirational goal in psychiatry, despite significant advances in our understanding of the biochemical, genetic and neurobiological processes underlying major mental disorders. Preventive medicine relies on the availability of predictive tools; in psychiatry we still largely lack these. Furthermore, our current diagnostic systems, with their focus on well-established, largely chronic illness, do not support a pre-emptive, let alone a preventive, approach, since it is during the early stages of a disorder that interventions have the potential to offer the greatest benefit. Here, we present a clinical staging model for severe mental disorders and discuss examples of biological markers that have already undergone some systematic evaluation and that could be integrated into such a framework. The advantage of this model is that it explicitly considers the evolution of psychopathology during the development of a mental illness and emphasizes that progression of illness is by no means inevitable, but can be altered by providing appropriate interventions that target individual modifiable risk and protective factors. The specific goals of therapeutic intervention are therefore broadened to include the prevention of illness onset or progression, and to minimize the risk of harm associated with more complex treatment regimens. The staging model also facilitates the integration of new data on the biological, social and environmental factors that influence mental illness into our clinical and diagnostic infrastructure, which will provide a major step forward in the development of a truly pre-emptive psychiatry.
Language eng
DOI 10.1002/wps.20144
Field of Research 110319 Psychiatry (incl Psychotherapy)
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, John Wiley & Sons
Persistent URL http://hdl.handle.net/10536/DRO/DU:30068178

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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