Evidence map›Paper›PMID 42328781›Full record

ReviewEarly intervention in psychiatry2026

The Staging Model in Psychosis and Preventive Interventions: An Emerging Field With Debates on Conceptual Models and Interpretation of the Evidence Base.

Mark van der Gaag, Cristina Mei, Barnaby Nelson, Maximus Berger, Marija Krcmar, G Paul Amminger, Andreas Bechdolf, Paul Hutton, Pim Cuijpers, Alison R Yung and 1 more

Abstract readReview
In one paragraph

Review in Early intervention in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mark van der GaagDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Cristina MeiOrygen, Parkville, Victoria, Australia.ORCID https://orcid.org/0000-0002-6765-8064
Barnaby NelsonOrygen, Parkville, Victoria, Australia.
Maximus BergerCentre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
Marija KrcmarOrygen, Parkville, Victoria, Australia.
G Paul AmmingerOrygen, Parkville, Victoria, Australia.ORCID https://orcid.org/0000-0001-8969-4595
Andreas BechdolfDepartment of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ Am Urban and Soulspace, Vivantes Hospital Am Urban and Im Friedrichshain, Berlin, Germany.
Paul HuttonSchool of Health & Social Care, Edinburgh Napier University, Edinburgh, Scotland.
Pim CuijpersDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Alison R YungSchool of Health Sciences, University of Manchester, Manchester, UK.
Patrick D McGorryOrygen, Parkville, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe staging model in psychiatry is heuristic and evolving, provoking debate and stimulating alternative views. This paper reviews major controversies in the field of staging and prevention of psychosis.

methodsWe review the literature on the classification model, the continuum model and the dynamic systems model applied to psychiatry. Other controversies are stigmatisation of early detection, the prevention paradox and the interpretation of data on prevention of transition to psychosis.

resultsDSM classifications still lack validity. The continuum model supports preclinical stages but has no discrete conversions to different stages of illness. The emerging dynamic systems model builds on the interaction of symptoms eliciting networks of symptoms, while at the same time it explains sudden catastrophic shifts (transitions) between different states of equilibrium. Stigmatisation of early psychosis can be balanced against the benefits of early interventions. The prevention paradox states that only a minority of first episode cases arises from the high-risk group. However, there are many reasons to combine indicated prevention with population-based preventive interventions. A long-lasting controversy is on the interpretation of the research data. Several meta-analyses are reviewed on methodological issues.

conclusionThe staging model is adequate to conceptualise psychiatric disorders and the progress over time in more chronic stages. No one is suggesting that help-seeking patients with an ARMS should be denied access to psychosocial treatment and it is recommended and necessary to continue building age and stage specific services to treat them and continue with research into risk factors and helpful interventions.

Indexed as

Models, PsychologicalPsychotic DisordersEarly DiagnosisHumansProdromal Symptomsclinical high riskcognitive behavioral therapypreventionpsychosisstaging model

Identifiers

PMID42328781
PMCPMC13285004

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.