- For anxiety, mood, and psychotic disorders, the stage at which an adolescent presents for care factors into their condition’s trajectory and progression.
- This study identifies stage-to-stage transition points and factors that signal progression.
Why this matters
- Awareness of red-flag factors marking progression, such as circadian disruption, can aid clinical recognition.
- Editorial: this framework holds potential for offering “substantial advances” in clinical understanding of how these conditions progress and appropriate treatment options.
- Ia: early subthreshold, nonspecific symptoms of, e.g., anxiety, depression;
- Ib: attenuated syndromes that may meet diagnostic criteria, but with mild or short-term presentation; and
- II: meet diagnostic criteria for a disorder that is persistent or recurrent.
- Factors associated with stage-to-stage transition:
- Ia to Ib: low social functioning; low engagement with education/employment; manic/psychotic-like episodes, self-harm, older age.
- Ib to II: psychotic-like experiences, circadian disturbances, history of childhood psychiatric disorder, older age.
- Longitudinal, observational study in Australia; 2254 people (59.0% female) ages 12-25 (baseline mean, 18.18) years who had contact with mental health care at 2 early-intervention centers.
- Median follow-up, 14 (interquartile range, 5-33) months.
- Outcome: transition from earlier to later stage.
- Funding: National Health & Medical Research Council Center of Research Excellence; Australia Fellowship.
- Selected cohort; results not necessarily generalizable.