{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:25:09Z","timestamp":1792718709327,"version":"4.5.0"},"reference-count":75,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Mol Psychiatry"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Modelling the prodrome to severe mental disorders (SMD), including unipolar mood disorders (UMD), bipolar mood disorders (BMD) and psychotic disorders (PSY), should consider both the evolution and interactions of symptoms and substance use (prodromal features) over time. Temporal network analysis can detect causal dependence between and within prodromal features by representing prodromal features as nodes, with their connections (edges) indicating the likelihood of one feature preceding the other. In SMD, node centrality could reveal insights into important prodromal features and potential intervention targets. Community analysis can identify commonly occurring feature groups to define SMD at-risk states. This retrospective (2-year) cohort study aimed to develop a global transdiagnostic SMD network of the temporal relationships between prodromal features and to examine within-group differences with sub-networks specific to UMD, BMD and PSY. Electronic health records (EHRs) from South London and Maudsley\u00a0(SLaM) NHS Foundation Trust were included from 6462 individuals with SMD diagnoses (UMD:2066; BMD:740; PSY:3656). Validated natural language processing algorithms extracted the occurrence of 61 prodromal features every three months from two years to six months before SMD onset. Temporal networks of prodromal features were constructed using generalised vector autoregression panel analysis, adjusting for covariates. Edge weights (partial directed correlation coefficients,\n                    <jats:italic>z<\/jats:italic>\n                    ) were reported in autocorrelative, unidirectional and bidirectional relationships. Centrality was calculated as the sum of (non-autoregressive) connections leaving (out-centrality,\n                    <jats:italic>c<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>out<\/jats:italic>\n                    <\/jats:sub>\n                    ) or entering (in-centrality,\n                    <jats:italic>c<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>in<\/jats:italic>\n                    <\/jats:sub>\n                    ) a node. The three sub-networks (UMD, BMD, PSY) were compared using permutation analysis, and community analysis was performed using Spinglass. The SMD network revealed strong autocorrelations (0.04\u2009\u2264\u2009\n                    <jats:italic>z<\/jats:italic>\n                    \u2009\u2264\u20090.10), predominantly positive connections, and identified aggression (\n                    <jats:italic>c<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>out<\/jats:italic>\n                    <\/jats:sub>\n                    \u2009=\u20090.103) and tearfulness (\n                    <jats:italic>c<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>in<\/jats:italic>\n                    <\/jats:sub>\n                    \u2009=\u20090.134) as the most central features. Sub-networks for UMD, BMD, and PSY showed minimal differences, with 3.5% of edges differing between UMD and PSY, 0.8% between UMD and BMD, and 0.4% between BMD and PSY. Community analysis identified one positive psychotic community (delusional thinking-hallucinations-paranoia) and two behavioural communities (aggression-cannabis use-cocaine use-hostility, aggression-agitation-hostility) as the most common. This study represents the most extensive temporal network analysis conducted on the longitudinal interplay of SMD prodromal features. The findings provide further evidence to support transdiagnostic early detection services across SMD, refine assessments to detect individuals at risk and identify central features as potential intervention targets.\n                  <\/jats:p>","DOI":"10.1038\/s41380-025-02896-3","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T11:15:26Z","timestamp":1737544526000},"page":"2931-2942","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Longitudinal evolution of the transdiagnostic prodrome to severe mental disorders: a dynamic temporal network analysis informed by natural language processing and electronic health records"],"prefix":"10.1038","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0182-3493","authenticated-orcid":false,"given":"Maite","family":"Arribas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Barnby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9259-8788","authenticated-orcid":false,"given":"Rashmi","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1102-2566","authenticated-orcid":false,"given":"Robert A.","family":"McCutcheon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisy","family":"Kornblum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitesh","family":"Shetty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil","family":"Krakowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7987-6619","authenticated-orcid":false,"given":"Daniel","family":"Stahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Koutsouleris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4381-0532","authenticated-orcid":false,"given":"Philip","family":"McGuire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3582-6788","authenticated-orcid":false,"given":"Paolo","family":"Fusar-Poli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8920-3407","authenticated-orcid":false,"given":"Dominic","family":"Oliver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"2896_CR1","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1159\/000528513","volume":"56","author":"A Estrad\u00e9","year":"2023","unstructured":"Estrad\u00e9 A, Onwumere J, Venables J, Gilardi L, Cabrera A, Rico J, et al. The lived experiences of family members and carers of people with psychosis: a bottom-up review co-written by experts by experience and academics. Psychopathology. 2023;56:371\u201382.","journal-title":"Psychopathology"},{"key":"2896_CR2","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1002\/wps.20959","volume":"21","author":"P Fusar-Poli","year":"2022","unstructured":"Fusar-Poli P, Estrad\u00e9 A, Stanghellini G, Venables J, Onwumere J, Messas G, et al. The lived experience of psychosis: a bottom-up review co-written by experts by experience and academics. World Psychiatry. 2022;21:168\u201388.","journal-title":"World Psychiatry"},{"key":"2896_CR3","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1002\/wps.21111","volume":"22","author":"P Fusar-Poli","year":"2023","unstructured":"Fusar-Poli P, Estrad\u00e9 A, Stanghellini G, Esposito CM, Rosfort R, Mancini M, et al. The lived experience of depression: a bottom-up review co-written by experts by experience and academics. World Psychiatry. 2023;22:352\u201365.","journal-title":"World Psychiatry"},{"key":"2896_CR4","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.biopsych.2024.02.1006","volume":"96","author":"D Oliver","year":"2024","unstructured":"Oliver D, Arribas M, Perry BI, Whiting D, Blackman G, Krakowski K, et al. Using electronic health records to facilitate precision psychiatry. Biol Psychiatry. 2024;96:532\u201342.","journal-title":"Biol Psychiatry"},{"key":"2896_CR5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s43586-021-00055-w","volume":"1","author":"D Borsboom","year":"2021","unstructured":"Borsboom D, Deserno MK, Rhemtulla M, Epskamp S, Fried EI, McNally RJ, et al. Network analysis of multivariate data in psychological science. Nat Rev Methods Primers. 2021;1:1\u201318.","journal-title":"Nat Rev Methods Primers"},{"key":"2896_CR6","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1192\/bjp.2024.19","volume":"224","author":"OV Ebrahimi","year":"2024","unstructured":"Ebrahimi OV, Borsboom D, Hoekstra RHA, Epskamp S, Ostinelli EG, Bastiaansen JA, et al. Towards precision in the diagnostic profiling of patients: leveraging symptom dynamics as a clinical characterisation dimension in the assessment of major depressive disorder. Br J Psychiatry. 2024;224:157\u201363.","journal-title":"Br J Psychiatry"},{"key":"2896_CR7","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1177\/1754073915590623","volume":"7","author":"M Wichers","year":"2015","unstructured":"Wichers M, Wigman JTW, Myin-Germeys I. Micro-level affect dynamics in psychopathology viewed from complex dynamical system theory. Emot Rev. 2015;7:362\u20137.","journal-title":"Emot Rev"},{"key":"2896_CR8","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1177\/0956797610372634","volume":"21","author":"P Kuppens","year":"2010","unstructured":"Kuppens P, Allen NB, Sheeber LB. Emotional inertia and psychological maladjustment. Psychol Sci. 2010;21:984\u201391.","journal-title":"Psychol Sci"},{"key":"2896_CR9","doi-asserted-by":"crossref","first-page":"424","DOI":"10.2307\/1912791","volume":"37","author":"CWJ Granger","year":"1969","unstructured":"Granger CWJ. Investigating causal relations by econometric models and cross-spectral methods. Econometrica. 1969;37:424\u201338.","journal-title":"Econometrica"},{"key":"2896_CR10","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1177\/2167702617744325","volume":"6","author":"S Epskamp","year":"2018","unstructured":"Epskamp S, van Borkulo CD, van der Veen DC, Servaas MN, Isvoranu A-M, Riese H, et al. Personalized network modeling in psychopathology: the importance of contemporaneous and temporal connections. Clin Psychol Sci. 2018;6:416\u201327.","journal-title":"Clin Psychol Sci"},{"key":"2896_CR11","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.schres.2016.09.002","volume":"178","author":"SZ Levine","year":"2016","unstructured":"Levine SZ, Leucht S. Identifying a system of predominant negative symptoms: network analysis of three randomized clinical trials. Schizophr Res. 2016;178:17\u201322.","journal-title":"Schizophr Res"},{"key":"2896_CR12","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.brat.2016.06.006","volume":"86","author":"RJ McNally","year":"2016","unstructured":"McNally RJ. Can network analysis transform psychopathology? Behav Res Ther. 2016;86:95\u2013104.","journal-title":"Behav Res Ther"},{"key":"2896_CR13","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1159\/000341757","volume":"81","author":"E Tomba","year":"2012","unstructured":"Tomba E, Bech P. Clinimetrics and clinical psychometrics: macro- and micro-analysis. Psychother Psychosom. 2012;81:333\u201343.","journal-title":"Psychother Psychosom"},{"key":"2896_CR14","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1001\/jamapsychiatry.2015.2079","volume":"72","author":"C van Borkulo","year":"2015","unstructured":"van Borkulo C, Boschloo L, Borsboom D, Penninx BWJH, Waldorp LJ, Schoevers RA. Association of symptom network structure with the course of [corrected] depression. JAMA Psychiatry. 2015;72:1219\u201326.","journal-title":"JAMA Psychiatry"},{"key":"2896_CR15","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1016\/j.euroneuro.2016.09.368","volume":"26","author":"M Madhoo","year":"2016","unstructured":"Madhoo M, Levine SZ. Network analysis of the quick inventory of depressive symptomatology: reanalysis of the STAR*D clinical trial. Eur Neuropsychopharmacol. 2016;26:1768\u201374.","journal-title":"Eur Neuropsychopharmacol"},{"key":"2896_CR16","volume":"6","author":"Z Yang","year":"2016","unstructured":"Yang Z, Algesheimer R, Tessone CJ. A comparative analysis of community detection algorithms on artificial networks. Sci Rep. 2016;6:30750.","journal-title":"Sci Rep"},{"key":"2896_CR17","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-018-24224-2","volume":"8","author":"TF Blanken","year":"2018","unstructured":"Blanken TF, Deserno MK, Dalege J, Borsboom D, Blanken P, Kerkhof GA, et al. The role of stabilizing and communicating symptoms given overlapping communities in psychopathology networks. Sci Rep. 2018;8:5854.","journal-title":"Sci Rep"},{"key":"2896_CR18","doi-asserted-by":"crossref","DOI":"10.1186\/1471-244X-9-51","volume":"9","author":"R Stewart","year":"2009","unstructured":"Stewart R, Soremekun M, Perera G, Broadbent M, Callard F, Denis M, et al. The South London and Maudsley NHS foundation trust biomedical research centre (SLAM BRC) case register: development and descriptive data. BMC Psychiatry. 2009;9:51.","journal-title":"BMC Psychiatry"},{"key":"2896_CR19","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1016\/S0140-6736(15)01223-4","volume":"387","author":"E Roberts","year":"2016","unstructured":"Roberts E, Wessely S, Chalder T, Chang C-K, Hotopf M. Mortality of people with chronic fatigue syndrome: a retrospective cohort study in England and Wales from the South London and Maudsley NHS foundation trust biomedical research centre (SLaM BRC) clinical record interactive search (CRIS) register. Lancet. 2016;387:1638\u201343.","journal-title":"Lancet"},{"key":"2896_CR20","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1016\/S2215-0366(15)00290-4","volume":"2","author":"S Oram","year":"2015","unstructured":"Oram S, Khondoker M, Abas M, Broadbent M, Howard LM. Characteristics of trafficked adults and children with severe mental illness: a historical cohort study. Lancet Psychiatry. 2015;2:1084\u201391.","journal-title":"Lancet Psychiatry"},{"key":"2896_CR21","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1001\/jamapsychiatry.2016.2707","volume":"73","author":"P Fusar-Poli","year":"2016","unstructured":"Fusar-Poli P, Rutigliano G, Stahl D, Schmidt A, Ramella-Cravaro V, Hitesh S, et al. Deconstructing pretest risk enrichment to optimize prediction of psychosis in individuals at clinical high risk. JAMA Psychiatry. 2016;73:1260\u20137.","journal-title":"JAMA Psychiatry"},{"key":"2896_CR22","doi-asserted-by":"crossref","DOI":"10.1038\/s41398-020-01165-x","volume":"11","author":"G Salazar de Pablo","year":"2021","unstructured":"Salazar de Pablo G, Estrad\u00e9 A, Cutroni M, Andlauer O, Fusar-Poli P. Establishing a clinical service to prevent psychosis: what, how and when? Systematic review. Transl Psychiatry. 2021;11:43.","journal-title":"Transl Psychiatry"},{"key":"2896_CR23","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1080\/00273171.2018.1454823","volume":"53","author":"S Epskamp","year":"2018","unstructured":"Epskamp S, Waldorp LJ, M\u00f5ttus R, Borsboom D. The gaussian graphical model in cross-sectional and time-series data. Multivar Behav Res. 2018;53:453\u201380.","journal-title":"Multivar Behav Res"},{"key":"2896_CR24","doi-asserted-by":"crossref","first-page":"e012012","DOI":"10.1136\/bmjopen-2016-012012","volume":"7","author":"RG Jackson","year":"2017","unstructured":"Jackson RG, Patel R, Jayatilleke N, Kolliakou A, Ball M, Gorrell G, et al. Natural language processing to extract symptoms of severe mental illness from clinical text: the clinical record interactive search comprehensive data extraction (CRIS-CODE) project. BMJ Open. 2017;7:e012012.","journal-title":"BMJ Open"},{"key":"2896_CR25","doi-asserted-by":"crossref","unstructured":"Barnby JM, Haslbeck JMB, Rosen C, Harrow M. Modelling the longitudinal dynamics of paranoia in psychosis: a temporal network analysis over 20 years. 2024:270:465\u201375.","DOI":"10.1016\/j.schres.2024.06.055"},{"key":"2896_CR26","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1007\/s11336-020-09697-3","volume":"85","author":"S Epskamp","year":"2020","unstructured":"Epskamp S. Psychometric network models from time-series and panel data. Psychometrika. 2020;85:206\u201331.","journal-title":"Psychometrika"},{"key":"2896_CR27","unstructured":"Epskamp S. psychonetrics: structural equation modeling and confirmatory network analysis. https:\/\/cran.r-project.org\/web\/packages\/psychonetrics\/index.html. Accessed 18 January 2025."},{"key":"2896_CR28","doi-asserted-by":"crossref","first-page":"195","DOI":"10.3758\/s13428-017-0862-1","volume":"50","author":"S Epskamp","year":"2018","unstructured":"Epskamp S, Borsboom D, Fried EI. Estimating psychological networks and their accuracy: a tutorial paper. Behav Res. 2018;50:195\u2013212.","journal-title":"Behav Res"},{"key":"2896_CR29","doi-asserted-by":"crossref","first-page":"267","DOI":"10.3200\/JEXE.74.3.267-288","volume":"74","author":"SA Sivo","year":"2006","unstructured":"Sivo SA, Fan X, Witta EL, Willse JT. The search for \u2018optimal\u2019 cutoff properties: fit index criteria in structural equation modeling. J Exp Educ. 2006;74:267\u201388.","journal-title":"J Exp Educ"},{"key":"2896_CR30","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1002\/spe.4380211102","volume":"21","author":"TMJ Fruchterman","year":"1991","unstructured":"Fruchterman TMJ, Reingold EM. Graph drawing by force-directed placement. Software Pract Exper. 1991;21:1129\u201364.","journal-title":"Software Pract Exper"},{"key":"2896_CR31","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1017\/S0033291709990651","volume":"39","author":"A Demjaha","year":"2009","unstructured":"Demjaha A, Morgan K, Morgan C, Landau S, Dean K, Reichenberg A, et al. Combining dimensional and categorical representation of psychosis: the way forward for DSM-V and ICD-11? Psychol Med. 2009;39:1943\u201355.","journal-title":"Psychol Med"},{"key":"2896_CR32","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/S0920-9964(00)00190-0","volume":"52","author":"MJ Cuesta","year":"2001","unstructured":"Cuesta MJ, Peralta V. Integrating psychopathological dimensions in functional psychoses: a hierarchical approach. Schizophr Res. 2001;52:215\u201329.","journal-title":"Schizophr Res"},{"key":"2896_CR33","unstructured":"CRIS Natural Language Processing. https:\/\/www.maudsleybrc.nihr.ac.uk\/facilities\/clinical-record-interactive-search-cris\/cris-natural-language-processing\/. Accessed 4 January 2024."},{"key":"2896_CR34","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.socnet.2019.08.001","volume":"59","author":"MM Fredrickson","year":"2019","unstructured":"Fredrickson MM, Chen Y. Permutation and randomization tests for network analysis. Soc Netw. 2019;59:171\u201383.","journal-title":"Soc Netw"},{"key":"2896_CR35","unstructured":"cluster_spinglass function - RDocumentation. https:\/\/www.rdocumentation.org\/packages\/igraph\/versions\/1.2.5\/topics\/cluster_spinglass. Accessed 9 April 2024."},{"key":"2896_CR36","doi-asserted-by":"crossref","first-page":"036115","DOI":"10.1103\/PhysRevE.80.036115","volume":"80","author":"VA Traag","year":"2009","unstructured":"Traag VA, Bruggeman J. Community detection in networks with positive and negative links. Phys Rev E. 2009;80:036115.","journal-title":"Phys Rev E"},{"key":"2896_CR37","doi-asserted-by":"crossref","first-page":"016110","DOI":"10.1103\/PhysRevE.74.016110","volume":"74","author":"J Reichardt","year":"2006","unstructured":"Reichardt J, Bornholdt S. Statistical mechanics of community detection. Phys Rev E. 2006;74:016110.","journal-title":"Phys Rev E"},{"key":"2896_CR38","doi-asserted-by":"publisher","unstructured":"Werner M. The ComDet package - iterated community detection for the analysis of community membership, its stability and the detection of fuzzy community boundaries. 2018. https:\/\/doi.org\/10.31219\/osf.io\/bwsq7.","DOI":"10.31219\/osf.io\/bwsq7"},{"key":"2896_CR39","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1146\/annurev-devpsych-050620-030405","volume":"3","author":"PD McGorry","year":"2021","unstructured":"McGorry PD, Mei C. Clinical staging for youth mental disorders: progress in reforming diagnosis and clinical care. Annu Rev Developmental Psychol. 2021;3:15\u201339.","journal-title":"Annu Rev Developmental Psychol"},{"key":"2896_CR40","doi-asserted-by":"crossref","unstructured":"Arribas M, Oliver D, Patel R, Kornblum D, Shetty H, Damiani S, et al. A transdiagnostic prodrome for severe mental disorders: an electronic health record study. Mol Psychiatry. 2024;29:3305\u201315.","DOI":"10.1038\/s41380-024-02533-5"},{"key":"2896_CR41","doi-asserted-by":"crossref","first-page":"105626","DOI":"10.1016\/j.neubiorev.2024.105626","volume":"160","author":"D Oliver","year":"2024","unstructured":"Oliver D. The future of preventive psychiatry is precise and transdiagnostic. Neurosci Biobehav Rev. 2024;160:105626.","journal-title":"Neurosci Biobehav Rev"},{"key":"2896_CR42","doi-asserted-by":"crossref","unstructured":"Uhlhaas PJ, Davey CG, Mehta UM, Shah J, Torous J, Allen NB, et al. Towards a youth mental health paradigm: a perspective and roadmap. Mol Psychiatry. 2023;28:3171\u201381.","DOI":"10.1038\/s41380-023-02202-z"},{"key":"2896_CR43","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1002\/wps.20745","volume":"19","author":"JL Shah","year":"2020","unstructured":"Shah JL, Scott J, McGorry PD, Cross SPM, Keshavan MS, Nelson B, et al. Transdiagnostic clinical staging in youth mental health: a first international consensus statement. World Psychiatry. 2020;19:233\u201342.","journal-title":"World Psychiatry"},{"key":"2896_CR44","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1001\/jamapsychiatry.2019.2003","volume":"76","author":"JL Shah","year":"2019","unstructured":"Shah JL. Bringing clinical staging to youth mental health: from concept to operationalization (and back again). JAMA Psychiatry. 2019;76:1121\u20133.","journal-title":"JAMA Psychiatry"},{"key":"2896_CR45","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/S2215-0366(21)00467-3","volume":"9","author":"JL Shah","year":"2022","unstructured":"Shah JL, Jones N, van Os J, McGorry PD, G\u00fcl\u00f6ks\u00fcz S. Early intervention service systems for youth mental health: integrating pluripotentiality, clinical staging, and transdiagnostic lessons from early psychosis. Lancet Psychiatry. 2022;9:413\u201322.","journal-title":"Lancet Psychiatry"},{"key":"2896_CR46","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1002\/wps.20514","volume":"17","author":"PD McGorry","year":"2018","unstructured":"McGorry PD, Hartmann JA, Spooner R, Nelson B. Beyond the \u201cat risk mental state\u201d concept: transitioning to transdiagnostic psychiatry. World Psychiatry. 2018;17:133\u201342.","journal-title":"World Psychiatry"},{"key":"2896_CR47","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S2215-0366(24)00060-9","volume":"11","author":"J Scott","year":"2024","unstructured":"Scott J, Iorfino F, Capon W, Crouse J, Nelson B, Chanen AM, et al. Staging 2\u00b70: refining transdiagnostic clinical staging frameworks to enhance reliability and utility for youth mental health. Lancet Psychiatry. 2024;11:461\u201371.","journal-title":"Lancet Psychiatry"},{"key":"2896_CR48","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1111\/eip.12483","volume":"13","author":"JA Hartmann","year":"2019","unstructured":"Hartmann JA, Nelson B, Spooner R, Paul Amminger G, Chanen A, Davey CG, et al. Broad clinical high-risk mental state (CHARMS): methodology of a cohort study validating criteria for pluripotent risk. Early Interv Psychiatry. 2019;13:379\u201386.","journal-title":"Early Interv Psychiatry"},{"key":"2896_CR49","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1001\/jamapsychiatry.2019.2360","volume":"76","author":"F Iorfino","year":"2019","unstructured":"Iorfino F, Scott EM, Carpenter JS, Cross SP, Hermens DF, Killedar M, et al. Clinical stage transitions in persons aged 12 to 25 years presenting to early intervention mental health services with anxiety, mood, and psychotic disorders. JAMA Psychiatry. 2019;76:1167\u201375.","journal-title":"JAMA Psychiatry"},{"key":"2896_CR50","doi-asserted-by":"crossref","first-page":"1990","DOI":"10.1017\/S0033291720003840","volume":"52","author":"JS Carpenter","year":"2022","unstructured":"Carpenter JS, Scott J, Iorfino F, Crouse JJ, Ho N, Hermens DF, et al. Predicting the emergence of full-threshold bipolar I, bipolar II and psychotic disorders in young people presenting to early intervention mental health services. Psychol Med. 2022;52:1990\u20132000.","journal-title":"Psychol Med"},{"key":"2896_CR51","doi-asserted-by":"crossref","first-page":"553578","DOI":"10.3389\/fpsyt.2020.553578","volume":"11","author":"JA Hartmann","year":"2020","unstructured":"Hartmann JA, McGorry PD, Destree L, Amminger GP, Chanen AM, Davey CG, et al. Pluripotential risk and clinical staging: theoretical considerations and preliminary data from a transdiagnostic risk identification approach. Front Psychiatry. 2020;11:553578.","journal-title":"Front Psychiatry"},{"key":"2896_CR52","doi-asserted-by":"crossref","first-page":"115745","DOI":"10.1016\/j.psychres.2024.115745","volume":"333","author":"L Destr\u00e9e","year":"2024","unstructured":"Destr\u00e9e L, McGorry P, Chanen A, Ratheesh A, Davey C, Polari A, et al. Transdiagnostic risk identification: a validation study of the clinical high at risk mental state (CHARMS) criteria. Psychiatry Res. 2024;333:115745.","journal-title":"Psychiatry Res"},{"key":"2896_CR53","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"2896_CR54","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S0006-3223(02)01866-8","volume":"54","author":"AJ Rush","year":"2003","unstructured":"Rush AJ, Trivedi MH, Ibrahim HM, Carmody TJ, Arnow B, Klein DN, et al. The 16-Item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry. 2003;54:573\u201383.","journal-title":"Biol Psychiatry"},{"key":"2896_CR55","doi-asserted-by":"crossref","first-page":"3670","DOI":"10.1038\/s41380-022-01611-w","volume":"27","author":"D Oliver","year":"2022","unstructured":"Oliver D, Arribas M, Radua J, Salazar de Pablo G, De Micheli A, Spada G, et al. Prognostic accuracy and clinical utility of psychometric instruments for individuals at clinical high-risk of psychosis: a systematic review and meta-analysis. Mol Psychiatry. 2022;27:3670\u20138.","journal-title":"Mol Psychiatry"},{"key":"2896_CR56","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1080\/j.1440-1614.2005.01714.x","volume":"39","author":"AR Yung","year":"2005","unstructured":"Yung AR, Pan Yuen H, Mcgorry PD, Phillips LJ, Kelly D, et al. Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Aust N Z J Psychiatry. 2005;39:964\u201371.","journal-title":"Aust N Z J Psychiatry"},{"key":"2896_CR57","volume-title":"The Psychosis-Risk Syndrome: Handbook for Diagnosis and Follow-Up","author":"T McGlashan","year":"2010","unstructured":"McGlashan T, Walsh B, Woods S. The Psychosis-Risk Syndrome: Handbook for Diagnosis and Follow-Up. USA: Oxford University Press; 2010."},{"key":"2896_CR58","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/eip.13401","volume":"18","author":"J Addington","year":"2024","unstructured":"Addington J, Woods SW, Yung AR, Calkins ME, Fusar-Poli P. Harmonizing the structured interview for psychosis-risk syndromes (SIPS) and the comprehensive assessment of at-risk mental states (CAARMS): an initial approach. Early Interv Psychiatry. 2024;18:248\u201354.","journal-title":"Early Interv Psychiatry"},{"key":"2896_CR59","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1176\/appi.ajp.2014.14010035","volume":"172","author":"D Axelson","year":"2015","unstructured":"Axelson D, Goldstein B, Goldstein T, Monk K, Yu H, Hickey MB, et al. Diagnostic precursors to bipolar disorder in offspring of parents with bipolar disorder: a longitudinal study. AJP. 2015;172:638\u201346.","journal-title":"AJP"},{"key":"2896_CR60","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/bdi.12209","volume":"16","author":"CU Correll","year":"2014","unstructured":"Correll CU, Olvet DM, Auther AM, Hauser M, Kishimoto T, Carri\u00f3n RE, et al. The bipolar prodrome symptom interview and scale\u2013prospective (BPSS-P): description and validation in a psychiatric sample and healthy controls. Bipolar Disord. 2014;16:505\u201322.","journal-title":"Bipolar Disord"},{"key":"2896_CR61","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.psychres.2018.03.074","volume":"264","author":"P Fusar-Poli","year":"2018","unstructured":"Fusar-Poli P, De Micheli A, Rocchetti M, Cappucciati M, Ramella-Cravaro V, Rutigliano G, et al. Semistructured interview for bipolar at risk states (SIBARS). Psychiatry Res. 2018;264:302\u20139.","journal-title":"Psychiatry Res"},{"key":"2896_CR62","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1016\/j.jad.2011.06.043","volume":"136","author":"K Leopold","year":"2012","unstructured":"Leopold K, Ritter P, Correll CU, Marx C, \u00d6zg\u00fcrdal S, Juckel G, et al. Risk constellations prior to the development of bipolar disorders: rationale of a new risk assessment tool. J Affect Disord. 2012;136:1000\u201310.","journal-title":"J Affect Disord"},{"key":"2896_CR63","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.jad.2010.06.016","volume":"127","author":"A Bechdolf","year":"2010","unstructured":"Bechdolf A, Nelson B, Cotton SM, Chanen A, Thompson A, Kettle J, et al. A preliminary evaluation of the validity of at-risk criteria for bipolar disorders in help-seeking adolescents and young adults. J Affect Disord. 2010;127:316\u201320.","journal-title":"J Affect Disord"},{"key":"2896_CR64","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.psychres.2016.12.029","volume":"249","author":"S-L Poe","year":"2017","unstructured":"Poe S-L, Brucato G, Bruno N, Arndt LY, Ben-David S, Gill KE, et al. Sleep disturbances in individuals at clinical high risk for psychosis. Psychiatry Res. 2017;249:240\u20133.","journal-title":"Psychiatry Res"},{"key":"2896_CR65","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1046\/j.1440-1614.2001.00912.x","volume":"35","author":"HY Tan","year":"2001","unstructured":"Tan HY, Ang YG. First-episode psychosis in the military: a comparative study of prodromal symptoms. Aust N Z J Psychiatry. 2001;35:512\u20139.","journal-title":"Aust N Z J Psychiatry"},{"key":"2896_CR66","doi-asserted-by":"crossref","first-page":"939","DOI":"10.2165\/00023210-200822110-00004","volume":"22","author":"S Cohrs","year":"2008","unstructured":"Cohrs S. Sleep disturbances in patients with schizophrenia: impact and effect of antipsychotics. CNS Drugs. 2008;22:939\u201362.","journal-title":"CNS Drugs"},{"key":"2896_CR67","doi-asserted-by":"crossref","first-page":"70","DOI":"10.3109\/13651501.2013.845219","volume":"18","author":"P Afonso","year":"2014","unstructured":"Afonso P, Brissos S, Ca\u00f1as F, Bobes J, Bernardo-Fernandez I. Treatment adherence and quality of sleep in schizophrenia outpatients. Int J Psychiatry Clin Pract. 2014;18:70\u20136.","journal-title":"Int J Psychiatry Clin Pract"},{"key":"2896_CR68","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1001\/jamapsychiatry.2018.4500","volume":"76","author":"G Gobbi","year":"2019","unstructured":"Gobbi G, Atkin T, Zytynski T, Wang S, Askari S, Boruff J, et al. Association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood: a systematic review and meta-analysis. JAMA Psychiatry. 2019;76:426\u201334.","journal-title":"JAMA Psychiatry"},{"key":"2896_CR69","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1001\/jamapsychiatry.2023.1256","volume":"80","author":"OH Jefsen","year":"2023","unstructured":"Jefsen OH, Erlangsen A, Nordentoft M, Hjorth\u00f8j C. Cannabis use disorder and subsequent risk of psychotic and nonpsychotic unipolar depression and bipolar disorder. JAMA Psychiatry. 2023;80:803\u201310.","journal-title":"JAMA Psychiatry"},{"key":"2896_CR70","first-page":"365","volume":"90","author":"G Benasi","year":"2021","unstructured":"Benasi G, Fava GA, Guidi J. Prodromal symptoms in depression: a systematic review. PPS. 2021;90:365\u201372.","journal-title":"PPS"},{"key":"2896_CR71","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1002\/wps.20490","volume":"17","author":"J Radua","year":"2018","unstructured":"Radua J, Ramella-Cravaro V, Ioannidis JPA, Reichenberg A, Phiphopthatsanee N, Amir T, et al. What causes psychosis? an umbrella review of risk and protective factors. World Psychiatry. 2018;17:49\u201366.","journal-title":"World Psychiatry"},{"key":"2896_CR72","doi-asserted-by":"crossref","unstructured":"Paquin V, Malla AK, Iyer SN, Lepage M, Joober R, Shah JL. Combinations and temporal associations among precursor symptoms before a first episode of psychosis. Schizophr Bull. 2024;50:860\u201370.","DOI":"10.1093\/schbul\/sbad152"},{"key":"2896_CR73","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.tics.2022.12.004","volume":"27","author":"JM Barnby","year":"2023","unstructured":"Barnby JM, Dayan P, Bell V. Formalising social representation to explain psychiatric symptoms. Trends Cognit Sci. 2023;27:317\u201332.","journal-title":"Trends Cognit Sci"},{"key":"2896_CR74","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.tics.2011.11.018","volume":"16","author":"PR Montague","year":"2012","unstructured":"Montague PR, Dolan RJ, Friston KJ, Dayan P. Computational psychiatry. Trends Cognit Sci. 2012;16:72\u201380.","journal-title":"Trends Cognit Sci"},{"key":"2896_CR75","first-page":"386","volume":"1","author":"MP Paulus","year":"2016","unstructured":"Paulus MP, Huys QJM, Maia TV. A roadmap for the development of applied computational psychiatry. Biol Psychiatry Cogn Neurosci Neuroimaging. 2016;1:386\u201392.","journal-title":"Biol Psychiatry Cogn Neurosci Neuroimaging"}],"container-title":["Molecular Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41380-025-02896-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41380-025-02896-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41380-025-02896-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T14:02:19Z","timestamp":1750687339000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41380-025-02896-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,22]]},"references-count":75,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["2896"],"URL":"https:\/\/doi.org\/10.1038\/s41380-025-02896-3","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2024.03.08.24303965","asserted-by":"object"}]},"ISSN":["1359-4184","1476-5578"],"issn-type":[{"value":"1359-4184","type":"print"},{"value":"1476-5578","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,22]]},"assertion":[{"value":"26 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 December 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 January 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"MA has been employed by F. Hoffmann-La Roche AG outside of the current study. RAM has received speaker\/consultancy fees from Boehringer Ingelheim, Janssen, Karuna, Lundbeck, Newron, Otsuka, and Viatris, and co-directs a company that designs digital resources to support treatment of mental ill health. RP has participated in a Scientific Advisory Board for Boehringer Ingelheim, has received grant funding from Janssen, and has received consulting fees from Holmusk, Akrivia Health, Columbia Data Analytics, Clinilabs, Social Finance, Boehringer Ingelheim, Bristol Myers Squibb, Teva and Otsuka. PFP has received research funds or personal fees from Lundbeck, Angelini, Menarini, Sunovion, Boehringer Ingelheim, Mindstrong, Proxymm Science, outside the current study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Permissions for the study were granted by the Oxfordshire Research Ethics Committee C; because the data set comprised deidentified data, informed consent was not required [\n                      \n                      ]. All methods were performed in accordance with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}