In one of the biggest studies of its kind, researchers have established a way to more accurately predict the onset of psychosis in high risk teenagers. The study, led by a team from UCLA and the National Institute of Mental Health (NIMH), involved 291 young people considered to be at risk for developing psychosis. The findings, published in the Archives of General Psychiatry, point to a feasible level of predictive accuracy in up to 80 per cent of high risk youth.
Lead researchers Tyrone D. Cannon, Ph.D., of the University of California Los Angeles, and Robert Heinssen, Ph.D., of NIMH, have demonstrated that teens who meet the most widely accepted criteria for risk can be identified 35 per cent of the time before they experience a psychotic episode within 30 months. However, certain combinations of factors can increase the prediction rate to as much as 80 per cent.
"We now have the ability to say with fairly good confidence, looking at an adolescent or a young adult person presenting with a particular constellation of risk factors, whether they're likely to get worse within two and a half years," stated Professor Cannon.
These combinations include:
- Lack of engagement in social activity, isolation, and a gradual deterioration in social functioning.
- Family history of psychosis combined with a recent decline in functioning such as unexplained drop in grades or withdrawal from extracurricular activities.
- An increase in thoughts such as 'other people are talking about me'.
- Past or current drug misuse and an increase in paranoia or suspicion.
The authors point out that whilst these are significant risk factors in predicting schizophrenia, they need to be thought of in the same way that high blood pressure is a significant risk factor in heart attacks; it does not guarantee it will happen. Like heart disease, the fact that a person is forewarned might help to reduce the odds of schizophrenia developing, such as avoiding drugs and alcohol or starting antipsychotic medication during the earliest onset of symptoms.
"The message here is that once we identify people as being at high risk, we have a very good chance of knowing whether or not they are likely to develop a serious mental disorder like schizophrenia and that, if they do, it will happen fairly quickly, " said Heinssen, who is also deputy director of the division of services and intervention at NIMH.
The next step is for more systematic testing. If these findings are confirmed it could help doctors identify, monitor and treat those people at higher risk. Early treatment with antipsychotic medication is thought to be associated with much more favorable outcomes.
Cannon. T.D., Cadenhead, K., Cornblatt, B., Woods, S. W., Addington, J., Walker, E., Seidman, L. J., Perkins, D., Tsuang, M., McGlashan, T., Heissen, R., Prediction of Psychosis in High Risk Youth: A multi-site longitudinal study in North America. Archives of General Psychiatry. 65(1): 28-37.