Psychiatry today faces a crisis of confidence in its approach to diagnosis. Traditional, rigid diagnostic categories defined by clinical features are under increasing strain as we find that these boundaries bear little resemblance to biology and have limited utility in guiding treatment or offering prognosis. Furthermore, our overreliance on binary classification methods places patients in discrete silos that do not reflect the dimensional nature of symptoms encountered.

Clinical Staging in Psychiatry, edited by Patrick McGorry and Ian Hickie, proposes an alternative approach based on transdiagnostic staging. In this highly readable book, they eloquently make the case for a staging model defined less by the discrete nature of symptoms and more by the temporal progression from prodrome through to first episode, relapse and eventually a chronic stage.

The book is organised into four broad sections, with each chapter authored by experts in their respective fields. The first section provides an overview of the approach to clinical staging and proposes a transdiagnostic staging model. The second discusses examples where progress has already been made by adopting a clinical staging approach to psychiatry, particularly in relation to psychotic and mood disorders. The third covers novel treatment approaches to mental health in areas already adopting a staging model. The final section considers how a staging approach could be applied in clinical practice.

The text is written in accessible language and broken into self-contained chapters that can be easily dipped into. This book will be of particular relevance to clinicians and researchers working in the field of mental health; however, it will also be of interest to social policy makers and providers of mental health and social services.

The book presents a compelling argument for a move towards a clinical stage approach in psychiatry. For many working on the front line in psychiatry, the book's central thesis will seem self-evident – that the nature of a psychiatric disorder, including the prognosis and treatment, depends greatly on the chronicity of symptoms. The advent of mental health services targeted at certain stages, such as early intervention services for psychosis, serves to demonstrate the clinical utility of a stage-based approach. Furthermore, a similar approach has already been adopted in some medical specialties, such as oncology, where cancer staging is a component of routine clinical practice, providing the basis for prognosis and treatment decisions.

A major theme permeating through the book is the disservice that the current classification system does to patients, and the urgent need to develop a more meaningful approach that better reflects the dynamic nature of psychiatric symptoms. Hopefully, this book will inspire researchers and clinicians alike to pick up the baton in this most noble of challenges.