Transdiagnostic phenotyping of psychopathology in a help-seeking population (PhenoNetz): A study protocol for an experience sampling study

Abstract

Background: Prevention in psychiatry provides a promising way to address the burden by mental illness. However, established approaches focus on specific diagnoses and do not address the heterogeneity and manifold potential outcomes of help-seeking populations that present at early recognition services. Thus, novel preventive approaches have been suggested, focusing on a broad transdiagnostic risk syndrome associated with different mental disorders. Conceptualizing such a pluripotent risk syndrome from a network perspective of interacting symptoms allows transdiagnostic investigations beyond binary disease categories. Furthermore, modern technologies such as smartphones facilitate the application of Experience Sampling Methods (ESM). A combination of ESM with network analyses provides valid insights beyond established assessment instruments. Methods: We will examine n = 75 individuals (age 18-40 years) of the help-seeking population of the Cologne early recognition centre (FETZ). For a maximally naturalistic sample, only minimal exclusion criteria will be applied. We will collect data for 14 days utilizing a mobile application to assess ten transdiagnostic symptoms, i.e., depressive, anxiety and psychotic symptoms as well as distress level. These data will allow to build both personalized and group symptom network models. Additionally, we will explore associations between symptom networks and sociodemographic, risk and resilience factors, as well as psychosocial functioning. Discussion: Our study will provide insights about feasibility and utility of ESM in a help-seeking population. Providing a first explorative phenotyping of the proposed broad transdiagnostic risk syndrome, this study will contribute to innovation of early recognition in psychiatry. Results will help to pave the way for prevention and targeted early intervention in a broader patient group and thus, enable greater intended effects in alleviating the burden of psychiatric disorders. In particular, individual insights provided by our study design are important in the context of precision medicine as well as for patients' own self-management.