{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T16:28:35Z","timestamp":1787329715317,"version":"build-2736575974"},"reference-count":68,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Early Intervention Psych"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DSM 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\u2010risk group. However, there are many reasons to combine indicated prevention with population\u2010based preventive interventions. A long\u2010lasting controversy is on the interpretation of the research data. Several meta\u2010analyses are reviewed on methodological issues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The staging model is adequate to conceptualise psychiatric disorders and the progress over time in more chronic stages. No one is suggesting that help\u2010seeking 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eip.70185","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:30:17Z","timestamp":1782127817000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Staging Model in Psychosis and Preventive Interventions: An Emerging Field With Debates on Conceptual Models and Interpretation of the Evidence Base"],"prefix":"10.1111","volume":"20","author":[{"given":"Mark","family":"van der Gaag","sequence":"first","affiliation":[{"name":"Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam  Amsterdam the Netherlands"},{"name":"Parnassia Psychiatric Institute  The Hague the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6765-8064","authenticated-orcid":false,"given":"Cristina","family":"Mei","sequence":"additional","affiliation":[{"name":"Orygen  Parkville Victoria Australia"},{"name":"Centre for Youth Mental Health The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barnaby","family":"Nelson","sequence":"additional","affiliation":[{"name":"Orygen  Parkville Victoria Australia"},{"name":"Centre for Youth Mental Health The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximus","family":"Berger","sequence":"additional","affiliation":[{"name":"Centre for Youth Mental Health The University of Melbourne  Parkville Victoria Australia"},{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy Medical University of Vienna  Vienna Austria"},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Krcmar","sequence":"additional","affiliation":[{"name":"Orygen  Parkville Victoria Australia"},{"name":"Centre for Youth Mental Health The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8969-4595","authenticated-orcid":false,"given":"G. Paul","family":"Amminger","sequence":"additional","affiliation":[{"name":"Orygen  Parkville Victoria Australia"},{"name":"Centre for Youth Mental Health The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Bechdolf","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ Am Urban and Soulspace Vivantes Hospital Am Urban and Im Friedrichshain  Berlin Germany"},{"name":"Department of Psychiatry and Psychotherapy, CCM Charit\u00e9\u2010Universit\u00e4tsmedizin  Berlin Germany"},{"name":"German Center of Mental Health (DZPG)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Hutton","sequence":"additional","affiliation":[{"name":"School of Health &amp; Social Care Edinburgh Napier University  Edinburgh Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim","family":"Cuijpers","sequence":"additional","affiliation":[{"name":"Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison R.","family":"Yung","sequence":"additional","affiliation":[{"name":"School of Health Sciences University of Manchester  Manchester UK"},{"name":"Institute for Mental and Physical Health and Clinical Translation (IMPACT) School of Medicine, Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick D.","family":"McGorry","sequence":"additional","affiliation":[{"name":"Orygen  Parkville Victoria Australia"},{"name":"Centre for Youth Mental Health The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/schizbullopen\/sgad020"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010017\u20101468\u2010y"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2018.07.022"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2019.08.030"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbad029"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbr083"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.109.066357"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380\u2010024\u201002415\u2010w"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715001944"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","unstructured":"Bosnjak Kuharic D. 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