Applying clinical staging to young people who present for mental health care

Ian B. Hickie*, Elizabeth M. Scott, Daniel F. Hermens, Sharon L. Naismith, Adam J. Guastella, Manreena Kaur, Anna Sidis, Bradley Whitwell, Nicholas Glozier, Tracey Davenport, Christos Pantelis, Stephen J. Wood, Patrick D. Mcgorry

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

167 Citations (Scopus)


Aim: The study aims to apply clinical staging to young people who present for mental health care; to describe the demographic features, patterns of psychological symptoms, disability correlates and clinical stages of those young people; and to report longitudinal estimates of progression from less to more severe stages. Methods: The study uses cross-sectional and longitudinal assessments of young people managed in specialized youth clinics. On the basis of clinical records, subjects were assigned to a specific clinical 'stage' (i.e. 'help-seeking', 'attenuated syndrome', 'discrete disorder' or 'persistent or recurrent illness'). Results: Young people (n=209, mean age=19.9years (range=12-30years), 48% female) were selected from a broader cohort of n=1483 subjects. Ten percent were assigned to the earliest 'help-seeking' stage, 54% to the 'attenuated syndrome' stage, 25% to the 'discrete disorder' stage and 11% to the later 'persistent or recurrent illness' stage. The interrater reliability of independent ratings at baseline was acceptable (κ=0.71). Subjects assigned to the 'attenuated syndrome' stage reported symptom and disability scores that were similar to those assigned to later stages. Longitudinally (median=48weeks), transition to later clinical stages were 11% of the 'help-seeking', 19% of the 'attenuated syndrome' and 33% of the 'discrete disorder' groups. Conclusion: Among young people presenting for mental health care, most are clinically staged as having 'attenuated syndromes'. Despite access to specialized treatment, a significant number progress to more severe or persistent disorders.

Original languageEnglish
Pages (from-to)31-43
Number of pages13
JournalEarly Intervention in Psychiatry
Issue number1
Publication statusPublished - Feb 2013
Externally publishedYes


  • Clinical staging
  • Diagnosis
  • Early intervention
  • Mental health
  • Youth


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