La recherche sur la clinique des troubles mentaux a été dynamisée, au cours des dernières décennies, par de nouvelles approches utilisant à la fois des données issues de travaux longitudinaux mais aussi des techniques statistiques les plus sophistiquées. Le modèle de staging, initialement développé dans le champ des psychoses débutantes, fournit aujourd’hui une grille de lecture appliquée aux troubles de l’humeur, aux troubles anxieux, voire aux troubles des conduites alimentaires et aux troubles addictifs. La notion de réseaux de symptômes, quant à elle, confirme la perception empirique, des relations de symptômes entre eux, permettant de centrer des stratégies de prise en charge sur les symptômes cibles, stratégiquement important. Ces approches cliniques sont le pendant des travaux d’exploration physiopathologique et étiopathogénique sur les troubles mentaux, portés notamment par la recherche dans le domaine de la génétique et de l’imagerie cérébrale. Elles ont une vertu heuristique et permettent une nouvelle approche des patients et de leur prise en charge.

Debate on the clinic of psychiatric disorders has been, for several decades, largely occupied by nosographic considerations resulting from the work which led to the publication of the DSM in its third version in 1980. However, DSM is a nomenclature, not a psychiatry manual and researches focusing on the clinic of mental disorders are essential in the progress of knowledge. Recently, in the field of psychotic disorders, new clinical approaches were developed, having heuristic value and having an impact on clinical practices. The staging model and the network theory of schizophrenia will be successively evoked, which are two fertile areas of these new clinical perspectives. Recent works to validate the staging model in schizophrenia, in large retrospective and prospective cohorts, found out two clinical models, conceptually congruent, in which, stages of the illness can be discriminated using symptoms, functioning and episodes. Each model would need to be tested in other independent samples to evaluate their reliability and accuracy. One of the findings of these works is that patients can improve or deteriorate from one stage to another, but prediction of the evolution remains uncertain. The next goals of research are to combine clinical evaluation with biomarkers, and also to develop the use of innovative statistical tools and methodologies in the field, to operationalize the concept of precision staging. On the other hand, regarding the network theory of schizophrenia, recent works highlight the interest of identifying networks of highly interrelated symptoms to focus on target symptoms and to develop specific treatment strategies. Clinical approaches are the counterpart of the physiopathological and etiopathogenic researches on mental disorders, carried out in particular by research in the field of genetics and brain imaging. The staging model and the network theory have a heuristic virtue and contribute to a new approach not only to schizophrenia but to all psychiatric disorders. In the daily clinical practice, they allow a new approach to patients and their care. Their interest has led to the development of professional recommendations for the management of schizophrenia, based on the staging model and particularly useful for clinicians.