Clinical staging and PID-5: a dimensional approach to diagnosis in the early stages of psychopathology

Abstract

Objective
The study presents the data on the use of a dimensional model complementary to the traditional categorical diagnosis, specifically applied to the mental health of young people and to the early clinical stages of emerging psychiatric disorders and psychosis.
Methods
For this goal, the data obtained from the assessment of young users were collected; subjects recruited were the first 100 attending at the Child and Adolescent Neuropsychiatry and Psychiatry Services of the ASST Melegnano and Martesana in the period 2018-2020, and enrolled in the Regional Innovative Projects dedicated to psychic disorders at a young age. The traditional diagnosis and the assessment of the mental state at risk were compared with the PID-5 Personality Inventory indexes (version extended to 220 items), based on the alternative model for personality disorders of Section III of DSM-5; we considered Domains, Traits and the specific psychopathological indices relating to Psychoticism domain.
Results
our data show that the more one advances in the progression stage of the disease (identified by the mental state at risk), the more there is a concordance with the traditional diagnosis. The diagnostic dispersion is higher in less vulnerable group. Our findings also suggest that PID-5 facets are more articulated in less compromised subjects and more coherent in the pre- and psychotic groups.
Conclusions
The finding of transversal, polymorphic and fluid pathological traits between the different diagnostic categories, especially in subjects in which a vulnerability in the level of risk of the mental state is recognized, suggest the usefulness of a dimensional approach complementary to traditional diagnosis, at least in the early stages of psychopathology.