Is there a symptomatic distinction between the affective psychoses and schizophrenia? A machine learning approach

Jauhar, Sameer; Krishnadas, Rajeev; Nour, Matthew M.; Cunningham-Owens, David G.; Johnstone, Eve C.; Lawrie, Stephen M.

doi:10.1016/j.schres.2018.06.070

Cited by 20 publications

(10 citation statements)

References 31 publications

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“…On the contrary, continuous (transdiagnostic) and categorical (specific‐diagnostic) dimensions frequently co‐exist in organic medicine (e.g., vascular surgery), as well as in psychiatry (e.g., the new DSM‐5 dimensional approach to personality disorders). In reality, transdiagnostic studies have also produced evidence to support the existence of diagnostic categories.…”

Section: Discussionmentioning

confidence: 99%

Transdiagnostic psychiatry: a systematic review

et al. 2019

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The usefulness of current psychiatric classification, which is based on ICD/DSM categorical diagnoses, remains questionable. A promising alternative has been put forward as the "transdiagnostic" approach. This is expected to cut across existing categorical diagnoses and go beyond them, to improve the way we classify and treat mental disorders. This systematic review explores whether self-defining transdiagnostic research meets such high expectations. A multi-step Web of Science literature search was performed according to an a priori protocol, to identify all studies that used the word "transdiagnostic" in their title, up to May 5, 2018. Empirical variables which indexed core characteristics were extracted, complemented by a bibliometric and conceptual analysis. A total of 111 studies were included. Most studies were investigating interventions, followed by cognition and psychological processes, and neuroscientific topics. Their samples ranged from 15 to 91,199 (median 148) participants, with a mean age from 10 to more than 60 (median 33) years. There were several methodological inconsistencies relating to the definition of the gold standard (DSM/ICD diagnoses), of the outcome measures and of the transdiagnostic approach. The quality of the studies was generally low and only a few findings were externally replicated. The majority of studies tested transdiagnostic features cutting across different diagnoses, and only a few tested new classification systems beyond the existing diagnoses. About one fifth of the studies were not transdiagnostic at all, because they investigated symptoms and not disorders, a single disorder, or because there was no diagnostic information. The bibliometric analysis revealed that transdiagnostic research largely restricted its focus to anxiety and depressive disorders. The conceptual analysis showed that transdiagnostic research is grounded more on rediscoveries than on true innovations, and that it is affected by some conceptual biases. To date, transdiagnostic approaches have not delivered a credible paradigm shift that can impact classification and clinical care. Practical "TRANSD"iagnostic recommendations are proposed here to guide future research in this field.

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Section: Discussionmentioning

confidence: 99%

Transdiagnostic psychiatry: a systematic review

et al. 2019

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“…For example, risk of mood disorders is significantly increased among offspring of parents with schizophrenia (relative risk, RR=1.62), while the risk of schizophrenia is significantly increased in offspring of parents with bipolar disorder (RR=6.42) 121 . However, there is also evidence for diagnostic specificity: machine learning reclassification studies demonstrated a distinction between schizophrenia and mood disorders 213 ; treatment requirements and outcomes also differ 55 . Similarly, while early neurocognitive functioning has been suggested as a promising transdiagnostic biomarker 214 , some studies suggest that it is more specific to psychosis than to common mental disorders 215 .…”

Section: Advancing Multivariable Transdiagnostic Multi-endpoint Epidemiological Knowledgementioning

confidence: 99%

Preventive psychiatry: a blueprint for improving the mental health of young people

et al. 2021

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Preventive approaches have latterly gained traction for improving mental health in young people. In this paper, we first appraise the conceptual foundations of preventive psychiatry, encompassing the public health, Gordon's, US Institute of Medicine, World Health Organization, and good mental health frameworks, and neurodevelopmentally‐sensitive clinical staging models. We then review the evidence supporting primary prevention of psychotic, bipolar and common mental disorders and promotion of good mental health as potential transformative strategies to reduce the incidence of these disorders in young people. Within indicated approaches, the clinical high‐risk for psychosis paradigm has received the most empirical validation, while clinical high‐risk states for bipolar and common mental disorders are increasingly becoming a focus of attention. Selective approaches have mostly targeted familial vulnerability and non‐genetic risk exposures. Selective screening and psychological/psychoeducational interventions in vulnerable subgroups may improve anxiety/depressive symptoms, but their efficacy in reducing the incidence of psychotic/bipolar/common mental disorders is unproven. Selective physical exercise may reduce the incidence of anxiety disorders. Universal psychological/psychoeducational interventions may improve anxiety symptoms but not prevent depressive/anxiety disorders, while universal physical exercise may reduce the incidence of anxiety disorders. Universal public health approaches targeting school climate or social determinants (demographic, economic, neighbourhood, environmental, social/cultural) of mental disorders hold the greatest potential for reducing the risk profile of the population as a whole. The approach to promotion of good mental health is currently fragmented. We leverage the knowledge gained from the review to develop a blueprint for future research and practice of preventive psychiatry in young people: integrating universal and targeted frameworks; advancing multivariable, transdiagnostic, multi‐endpoint epidemiological knowledge; synergically preventing common and infrequent mental disorders; preventing physical and mental health burden together; implementing stratified/personalized prognosis; establishing evidence‐based preventive interventions; developing an ethical framework, improving prevention through education/training; consolidating the cost‐effectiveness of preventive psychiatry; and decreasing inequalities. These goals can only be achieved through an urgent individual, societal, and global level response, which promotes a vigorous collaboration across scientific, health care, societal and governmental sectors for implementing preventive psychiatry, as much is at stake for young people with or at risk for emerging mental disorders.

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“…al. [38] acknowledged inherent issues with the Psychological diseases and concluded that there appear to be early continuing critiques about the indicative differentiation between effective psychosis and schizophrenia. Mohammad Alibakhshikenari et.…”

Section: Related Workmentioning

confidence: 99%