Psychotic disorders: The need for staging

BACKGROUND: In psychotic disorders it is the stage of development of the disease which mainly determines the prognosis and the effectiveness of treatment. AIM: To describe and to refine the current staging and profiling of psychotic disorders and to propose a way in which to describe the course of dimensions of psychoses. METHOD: We searched the literature for articles relating to the staging of psychotic disorders. RESULTS: McGorry e.a. developed a simple classification into stages which is currently applicable to research and clinical practice. We propose a further refinement in the form of a graph from which one can see in a glance the history of clinically relevant variation. CONCLUSION: Research into the prodromal stages of diseases is needed in order to elucidate the pathophysiological mechanisms that the stages have in common and to reveal the pathways of differential development.

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