TY - JOUR
T1 - Neuroimaging and treatment evidence for clinical staging in psychotic disorders
T2 - from the at-risk mental state to chronic schizophrenia
AU - Wood, Stephen J
AU - Yung, Alison R
AU - McGorry, Patrick D
AU - Pantelis, Christos
N1 - Copyright © 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
PY - 2011
Y1 - 2011
N2 - A new approach to understanding severe mental disorders such as schizophrenia is to adopt a clinical staging model. Such a model defines the extent of the illness such that earlier and milder phenomena are distinguished from later, more impairing features. Specifically, a clinical staging model makes three key predictions. First, pathologic measures should be more abnormal in more severe stages. Second, patients who progress between the stages should show change in these same pathologic measures. Finally, treatment should be more effective in the earlier stages, as well as more benign. In this article, we review the evidence for these three predictions from studies of psychotic disorders, with a focus on neuroimaging data. For all three, the balance of evidence supports the predictions of the staging model. However, there are a number of alternative explanations for these findings, including the effects of medication and symptom heterogeneity.
AB - A new approach to understanding severe mental disorders such as schizophrenia is to adopt a clinical staging model. Such a model defines the extent of the illness such that earlier and milder phenomena are distinguished from later, more impairing features. Specifically, a clinical staging model makes three key predictions. First, pathologic measures should be more abnormal in more severe stages. Second, patients who progress between the stages should show change in these same pathologic measures. Finally, treatment should be more effective in the earlier stages, as well as more benign. In this article, we review the evidence for these three predictions from studies of psychotic disorders, with a focus on neuroimaging data. For all three, the balance of evidence supports the predictions of the staging model. However, there are a number of alternative explanations for these findings, including the effects of medication and symptom heterogeneity.
U2 - 10.1016/j.biopsych.2011.05.034
DO - 10.1016/j.biopsych.2011.05.034
M3 - Article
C2 - 21762875
SN - 1873-2402
VL - 70
SP - 619
EP - 625
JO - Biological Psychiatry
JF - Biological Psychiatry
IS - 7
ER -