Previously, McGorry and colleagues (1,2) proposed the application of clinical staging models to psychiatric disorders, with a focus on psychoses and severe mood disorders. In this issue, Wood et al. (3) expand on this staging model for psychotic disorders, using pathophysiological data and treatment response data to evaluate key predictions associated with a valid staging model (3). The staging model proposed uses clinical criteria to define illness severity stages that progress from relatively few, mild, and nonspecific symptoms to an increasing number of more severe symptoms, including psychotic symptoms, neurocognitive impairments, comorbid conditions, and functional decline, culminating in the persistent disabling symptoms of chronic schizophrenia. Each stage is associated with an elevated risk for progression to the next stage. Although some patients progress through all of the stages, progression is not considered inevitable.
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