{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:36:54Z","timestamp":1791333414031,"version":"4.3.1"},"reference-count":46,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002999","name":"Ministerie van Volksgezondheid, Welzijn en Sport","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002999","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291721003445_sec_a1\"><jats:title>Background<\/jats:title><jats:p>A transdiagnostic and contextual framework of \u2018clinical characterization\u2019, combining clinical, psychopathological, sociodemographic, etiological, and other personal contextual data, may add clinical value over and above categorical algorithm-based diagnosis.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291721003445_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Prediction of need for care and health care outcomes was examined prospectively as a function of the contextual clinical characterization diagnostic framework in a prospective general population cohort (<jats:italic>n<\/jats:italic> = 6646 at baseline), interviewed four times between 2007 and 2018 (NEMESIS-2). Measures of need, service use, and use of medication were predicted as a function of any of 13 DSM-IV diagnoses, both separately and in combination with clinical characterization across multiple domains: social circumstances\/demographics, symptom dimensions, physical health, clinical\/etiological factors, staging, and polygenic risk scores (PRS). Effect sizes were expressed as population attributable fractions.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291721003445_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Any prediction of DSM-diagnosis in relation to need and outcome in separate models was entirely reducible to components of contextual clinical characterization in joint models, particularly the component of transdiagnostic symptom dimensions (a simple score of the number of anxiety, depression, mania, and psychosis symptoms) and staging (subthreshold, incidence, persistence), and to a lesser degree clinical factors (early adversity, family history, suicidality, slowness at interview, neuroticism, and extraversion), and sociodemographic factors. Clinical characterization components in combination predicted more than any component in isolation. PRS did not meaningfully contribute to any clinical characterization model.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291721003445_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>A transdiagnostic framework of contextual clinical characterization is of more value to patients than a categorical system of algorithmic ordering of psychopathology.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291721003445","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T08:03:51Z","timestamp":1629878631000},"page":"1825-1833","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":19,"title":["Context <i>v.<\/i> algorithm: evidence that a transdiagnostic framework of contextual clinical characterization is of more clinical value than categorical diagnosis"],"prefix":"10.1017","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7245-1586","authenticated-orcid":false,"given":"Jim","family":"van Os","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotta-Katrin","family":"Pries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margreet","family":"ten Have","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"de Graaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"van Dorsselaer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Bak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunter","family":"Kenis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bochao D.","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Gunther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurjen J.","family":"Luykx","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart P. F.","family":"Rutten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Guloksuz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,8,25]]},"reference":[{"key":"S0033291721003445_ref10","doi-asserted-by":"publisher","DOI":"10.1017\/S003329170002105X"},{"key":"S0033291721003445_ref18","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715000380"},{"key":"S0033291721003445_ref27","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20771"},{"key":"S0033291721003445_ref24","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000258"},{"key":"S0033291721003445_ref17","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20755"},{"key":"S0033291721003445_ref26","doi-asserted-by":"publisher","DOI":"10.1186\/s12991-020-00279-2"},{"key":"S0033291721003445_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-010-0334-8"},{"key":"S0033291721003445_ref12","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000482"},{"key":"S0033291721003445_ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-007-0179-y"},{"key":"S0033291721003445_ref33","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sby051"},{"key":"S0033291721003445_ref13","first-page":"388","volume-title":"The WHO world mental health surveys: Global perspectives on the epidemiology of mental disorders","author":"de Graaf","year":"2008"},{"key":"S0033291721003445_ref37","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.55.2.120"},{"key":"S0033291721003445_ref34","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.2304"},{"key":"S0033291721003445_ref39","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291714001561"},{"key":"S0033291721003445_ref41","doi-asserted-by":"publisher","DOI":"10.3109\/09638237.2010.492417"},{"key":"S0033291721003445_ref5","first-page":"8","article-title":"Sampling and methods of the European Study of the Epidemiology of Mental Disorders (ESEMeD) project","author":"Alonso","year":"2004","journal-title":"Acta Psychiatrica Scandinavica Supplementum"},{"key":"S0033291721003445_ref21","doi-asserted-by":"publisher","DOI":"10.1017\/S204579602100041X"},{"key":"S0033291721003445_ref19","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20794"},{"key":"S0033291721003445_ref2","volume-title":"STATA statistical software: Release 16","year":"2019"},{"key":"S0033291721003445_ref36","doi-asserted-by":"publisher","DOI":"10.1007\/s10902-015-9647-3"},{"key":"S0033291721003445_ref3","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.19.6.586"},{"key":"S0033291721003445_ref8","doi-asserted-by":"crossref","first-page":"602","DOI":"10.2105\/AJPH.90.4.602","article-title":"Psychiatric morbidity, service use, and need for care in the general population: Results of The Netherlands Mental Health Survey and Incidence Study","volume":"90","author":"Bijl","year":"2000","journal-title":"American Journal of Public Health"},{"key":"S0033291721003445_ref16","volume-title":"Mental illness in the community","author":"Goldberg","year":"1980"},{"key":"S0033291721003445_ref44","doi-asserted-by":"publisher","DOI":"10.1007\/s001270050243"},{"key":"S0033291721003445_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61268-9"},{"key":"S0033291721003445_ref11","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbq108"},{"key":"S0033291721003445_ref38","volume-title":"Measuring functioning and well-being: The medical outcomes study approach","author":"Stewart","year":"1992"},{"key":"S0033291721003445_ref40","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291714002372"},{"key":"S0033291721003445_ref31","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.3042"},{"key":"S0033291721003445_ref43","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291798008162"},{"key":"S0033291721003445_ref7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1509"},{"key":"S0033291721003445_ref45","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20609"},{"key":"S0033291721003445_ref42","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20046"},{"key":"S0033291721003445_ref6","article-title":"Analysis of shared heritability in common disorders of the brain","volume":"360","author":"Anttila","year":"2018","journal-title":"Science (New York, N.Y.)"},{"key":"S0033291721003445_ref22","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2011.10101531"},{"key":"S0033291721003445_ref35","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291718002635"},{"key":"S0033291721003445_ref30","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-021815-092954"},{"key":"S0033291721003445_ref14","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.317"},{"key":"S0033291721003445_ref20","doi-asserted-by":"publisher","DOI":"10.1017\/S003329172000183X"},{"key":"S0033291721003445_ref46","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbw177"},{"key":"S0033291721003445_ref32","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1301300402"},{"key":"S0033291721003445_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbaa086"},{"key":"S0033291721003445_ref23","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.3.022806.091532"},{"key":"S0033291721003445_ref25","first-page":"A14","article-title":"What does the population attributable fraction mean?","volume":"4","author":"Levine","year":"2007","journal-title":"Preventing Chronic Disease"},{"key":"S0033291721003445_ref1","doi-asserted-by":"publisher","DOI":"10.1038\/nature13595"},{"key":"S0033291721003445_ref9","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-050212-185608"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291721003445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T08:57:08Z","timestamp":1685091428000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291721003445\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,25]]},"references-count":46,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["S0033291721003445"],"URL":"https:\/\/doi.org\/10.1017\/s0033291721003445","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,25]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2021. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}