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Transdiagnostic psychiatry: a systematic review

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  1. Effectiveness of cognitive remediation in the ultra-high risk state for psychosis

    Research output: Contribution to journalLetterResearchpeer-review

  2. Mental illness among relatives of successful academics: implications for psychopathology-creativity research

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  3. Borderline personality disorder or a disorder within the schizophrenia spectrum? A psychopathological study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Testing a neurophenomenological model of basic self disturbance in early psychosis

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  1. 'The schizophrenic basic mood (self-disorder)', by Hans W Gruhle (1929)

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  2. The neurophenomenology of early psychosis: An integrative empirical study

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  3. Introduction - Section 15: Part III Taxonomy, Integration, and Multiple Levels of Explanation

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  4. Introduction - Section 4: Part II Phenomenology, Biological Psychology, and the Mind–body Problem

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  5. Introduction - Section 5: Part II Phenomenology, Biological Psychology, and the Mind–body Problem

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  • Paolo Fusar-Poli
  • Marco Solmi
  • Natascia Brondino
  • Cathy Davies
  • Chungil Chae
  • Pierluigi Politi
  • Stefan Borgwardt
  • Stephen M Lawrie
  • Josef Parnas
  • Philip McGuire
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The usefulness of current psychiatric classification, which is based on ICD/DSM categorical diagnoses, remains questionable. A promising alternative has been put forward as the "transdiagnostic" approach. This is expected to cut across existing categorical diagnoses and go beyond them, to improve the way we classify and treat mental disorders. This systematic review explores whether self-defining transdiagnostic research meets such high expectations. A multi-step Web of Science literature search was performed according to an a priori protocol, to identify all studies that used the word "transdiagnostic" in their title, up to May 5, 2018. Empirical variables which indexed core characteristics were extracted, complemented by a bibliometric and conceptual analysis. A total of 111 studies were included. Most studies were investigating interventions, followed by cognition and psychological processes, and neuroscientific topics. Their samples ranged from 15 to 91,199 (median 148) participants, with a mean age from 10 to more than 60 (median 33) years. There were several methodological inconsistencies relating to the definition of the gold standard (DSM/ICD diagnoses), of the outcome measures and of the transdiagnostic approach. The quality of the studies was generally low and only a few findings were externally replicated. The majority of studies tested transdiagnostic features cutting across different diagnoses, and only a few tested new classification systems beyond the existing diagnoses. About one fifth of the studies were not transdiagnostic at all, because they investigated symptoms and not disorders, a single disorder, or because there was no diagnostic information. The bibliometric analysis revealed that transdiagnostic research largely restricted its focus to anxiety and depressive disorders. The conceptual analysis showed that transdiagnostic research is grounded more on rediscoveries than on true innovations, and that it is affected by some conceptual biases. To date, transdiagnostic approaches have not delivered a credible paradigm shift that can impact classification and clinical care. Practical "TRANSD"iagnostic recommendations are proposed here to guide future research in this field.

Original languageEnglish
JournalWorld Psychiatry
Volume18
Issue number2
Pages (from-to)192-207
Number of pages16
ISSN1723-8617
DOIs
Publication statusPublished - Jun 2019

ID: 58973259