Psychosis risk may be detectable years before illnesses begin

A focus on specialist psychiatric services for children and adolescents may be an effective way of detecting individuals with a high psychosis risk at a very early stage, according to a recent study by the Finnish Institute for Health and Welfare (THL) and the Irish University College Dublin.

Psychotic disorders, such as schizophrenia and bipolar disorder, are among the most severe mental health disorders, said the THL in a press release on Thursday.

According to estimates by the World Health Organisation, 65 million people are affected by these disorders globally. They are also among the top 10 causes of disability.

Early intervention has been found to be associated with better treatment outcomes, but the current approaches capture only a very small proportion of all high-risk individuals.

Although psychotic disorders are rarely diagnosed before adulthood, up to 50% of all cases had, at some point, attended specialist child and adolescent psychiatry services.

“The results show that the existing services can reach up to half of those suffering from these serious disorders at a very early stage. In the future, we may be able to intervene in the development of the disorders, even in childhood, and possibly even prevent the disorders from emerging,” said Professor Ian Kelleher from University College Dublin.

According to the study, the risk was highest among those who had been admitted to adolescent psychiatric inpatient care. About 37% of them were diagnosed with psychosis or bipolar disorder by the age of 28 years.

“Particular attention should be paid to the assessment of psychosis risk of those in adolescent psychiatric inpatient care. Our research shows that more than one third of those who had received adolescent psychiatric inpatient care were diagnosed with psychosis or bipolar disorder by the age of 28. This information as well as register data on service use should be utilised in the development of early treatment and risk detection methods,” said visiting researcher of THL Ulla Lång.

The study used register data from THL's Finnish Birth Cohort 1987 study, which covers all children born in Finland in the year 1987. The subjects were followed until the age of 28 years. Information on the diagnoses of psychotic disorders and visits to specialist psychiatric care in childhood and adolescence was obtained from the Care Register for Health Care maintained by the THL.