Progression of Transdiagnostic Stages From Childhood to Young Adulthood
Notice bibliographique
Résumé
Importance: Transdiagnostic clinical staging models for mental disorders are receiving increased attention. However, their underlying assumptions are underresearched; for example, it is not clear whether the observed progression across stages occurs independently of preexisting risk factors. Objectives: To test the likelihood of progression from stage 0 (familial risk) in childhood to stage 1a (mild symptoms) in adolescence and subsequently to stage 1b (clinically significant symptoms) in young adulthood, accounting for confounders, and to explore potential mediators. Design, Setting, and Participants: This prospective cohort study included participants from the Avon Longitudinal Study of Parents and Children (ALSPAC). ALSPAC included pregnant women and their offspring residing in Avon, United Kingdom, between 1991 and 1992, with a proportion of offspring followed up into young adulthood. Eligible participants provided data on stage determinants and potential confounders from birth until age 24 years. Data were collected from 1991 to 2015 and analyzed from January 2002 to June 2025. Exposures: Exposures were clinical stages 0 and 1a in separate tests of association with stages 1a and 1b, respectively. Criteria for stage 0 were the presence of schizophrenia or severe depression in a first-degree relative. Criteria for stage 1a were the presence of 1 to 2 symptoms of depression, anxiety, or psychosis at ages 12 to 13 years. Main Outcomes and Measures: Outcomes were stage 1a in adolescence and stage 1b in young adulthood. Criteria for stage 1b were at least moderate symptoms of depression, anxiety, or psychosis, with associated functional impact at ages 18 to 24 years. Confounders were sex assigned at birth, obstetric risk, parental social class, ethnicity, family adversity, temperament, early life events, and neurocognition, measured in childhood. Results: Among those with complete data at all 3 time points (1375 participants; weighted, 7342), 796 participants (57.9%; weighted, 51.5%) were female and 579 (42.1%; weighted, 48.5%) were male. After adjusting for potential confounders, there was an association between stage 0 in childhood and stage 1a in adolescence (3860 participants; weighted, 7388 participants; odds ratio [OR], 1.65, 95% CI, 1.30-2.11) and between stage 1a in adolescence and stage 1b in young adulthood (1661 participants; weighted, 7466 participants; OR, 2.07; 95% CI, 1.07-4.01). Level of neuroticism in adolescence mediated 18% of the association between stage 1a in adolescence and stage 1b in young adulthood. Conclusions and Relevance: In this cohort study, young people with mental health problems meeting criteria for early clinical stages were at heightened risk of developing subsequent stages, independent of early life risk factors. This study supports the assumption of progression underlying clinical staging models for mental disorders.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».