Transdiagnostic psychiatry - the new frontier?

Transdiagnostic psychiatry - the new frontier?

16 October 2019

Researchers at Orygen are calling for a more holistic approach to identifying and treating young people at risk of a range of mental health conditions.

In an article published in World Psychiatry Professors Patrick McGorry and Barnaby Nelson are arguing for a transition to transdiagnostic approach to identifying risk for mental illness.

This involves applying a new set of clinical criteria to identify help-seeking young people who are at risk of progressing to a range of serious mental illnesses.

“We are seeking to build on the Clinical Staging Model to create a new diagnostic approach which will prove much more user friendly to clinicians, researchers and most importantly, young people and families.” Professor McGorry said.  “This is the central focus of my own NHMRC research fellowship and our Orygen-wide collaboration.”

“The ultra-high risk (UHR) approach to identifying and treating young people with mental ill-health, pioneered at Orygen, has been tremendously useful for detecting those at risk of developing schizophrenia and other psychotic disorders, Professor McGorry said. “But research is telling us that there are a number of routes to developing serious mental disorder.”

Professor Nelson said the aim is to refine these criteria, use them to test preventive treatments for a range of serious mental disorders, and also use them to help us understand exactly how mental disorders emerge.

“We know that there are many pathways into specific disorders so we’re trying to capitalise on that by having a broad, inclusive identification approach,” Professor Nelson said.

Professors McGorry and Nelson are trialling a transdiagnostic at risk approach at Orygen through the Clinical High at Risk Mental State (CHARMS) study so that preventive treatments can be implemented and causes can be better understood.

Professor Nelson said that although we are in the early stages of researching this transdiagnostic approach, preliminary data shows that young people who meet these broad at-risk criteria show a substantially higher rate of progressing to a range of serious mental disorders compared to those who don’t meet these criteria, despite receiving treatment.

“This indicates that the criteria seem to be working well in identifying this transdiagnostic at risk group.” he said.