From Run-to-Failure to Condition-Based Care: A Multi-Domain Framework for Preventive Psychiatry

This review proposes shifting psychiatry from reactive intervention to preventive condition-based care, drawing parallels from engineering maintenance practices. Evidence demonstrates that early psychological interventions reduce depression incidence by 43% post-treatment and 33% at follow-up, while shorter treatment delays improve response rates; the framework integrates five measurable domains (sleep, nutrition, allostatic load, autonomic function, immune function) with clinical staging models to enable scalable population-level prevention for depression and psychosis.