Norwegian Adult Mental Health Registry (NAMHR)

Abstract The model of clinical staging represents a new and important longitudinal perspective to current models on mental illness. The model incorporates many developmental and related conceptual frameworks, and allows for investigating mechanisms behind onset and trajectories of mental illness. The clinical staging model places people along a multidimensional continuum of health to illness to capture elements of risk, onset, course, and prognosis. The model highlights the fluid nature of mental illness in younger years and distinguishes between early and late clinical stages. Early stages are characterized by common symptoms and low predictivity, while later stages are characterized by persistence and impairment. This corresponds well with real-life clinical settings as diagnoses changing over time is common. To further complicate matters, the diagnostic criteria have been revised and are still being revised. Both individual diagnostic “drift” and criteria “drift” highlight the importance of trans-diagnostic quality registers. The NAMHR is a national naturalistic registry-based study, including all Norwegian adults eligible for treatment in public, specialized mental healthcare services who have not actively opted out. The registry is based on merging already collected data from the Norwegian Patient Registry (NPR), patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs), the Norwegian Registry for Primary Health Care (NRPHC), and several other sources including Electronic Health Records (EHR). This approach reduces strain on health professionals and participants. The registry collects information on diagnoses, treatments, medication, and patient-reported outcomes. Hopefully, the NAMHR will provide insights on both individual diagnostic “drift” and criteria “drift”, and with its large dataset, both regarding participants and variables, be usable for predicting impairment probability at an earlier stage.