Progression of Transdiagnostic Stages From Childhood to Young Adulthood

In transdiagnostic clinical staging models, is the observed progression of stages explained by confounders, such as early life risk factors?In this cohort study with 3860 participants, individuals with a first-degree family history of schizophrenia or depression (stage 0) in childhood were more likely to experience mild symptoms (stage 1a) in adolescence, and those at stage 1a in adolescence were more likely to develop moderate and impairing symptoms (stage 1b) in young adulthood, accounting for prospectively observed risk factors. Neuroticism mediated 18% of the association between stages 1a and 1b.Even independent of early life risk factors, the presence of a clinical stage conferred a higher risk of illness progression in this study.

Corresponding Author: Aswin Ratheesh, MD, PhD, School of Clinical Medicine, University of New South Wales, Black Dog Institute, Randwick NSW 2031 (a.ratheesh@unsw.edu.au).

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