A transdiagnostic model to prevention in mental and behavioral disorders: a comprehensive review and delineation of a new proposal
Graccielle Cunha, Andre Zugman, Pedro Pan, Lais Fonseca, Rodrigo Bressan, Cristiane S. Paula, Zila M. Sanchez, Jair Mari, Ary Gadelha
Abstract
Introduction
Current disease-specific models for prevention of mental disorders are challenged by the overlap of psychopathology, biological mechanisms, and risk factors. Moreover, mental disorders usually begin during childhood or adolescence, when symptoms fluctuate and are highly non-specific.
Discussion
We propose a staging model that integrates three domains - psychopathology, functional impairment and risk factors-, in which prevention is defined as actions to avoid stage progression, irrespective of diagnosis. Thus, preventive interventions should be broadened to include mental health promotion and strategies of risk reduction performed individually, at any stage, even for non-symptomatic subjects (before current at-risk definitions) currently exposed to risk factors.
Conclusion
The model features three innovations: a focus shift from disease conversion to stage progression, highlights functionality as an independent target, and acknowledgment of risk factors in the staging. The model must be validated before implementation.
Keywords
Submitted date:
06/27/2023
Accepted date:
10/21/2024