New targets identified for early detection and prevention of psychosis

A new study from the Center for Addiction and Mental Health (CAMH), titled Use of mental health services before first diagnosis of a psychotic disorder and published in JAMA Psychiatry, found that nearly 75 per cent of young Ontarians suffering from A psychotic disorder suffered from at least one visit to a mental health service in the three years before the first diagnosis of the disorder.

The retrospective cohort study, one of the largest of its kind, suggests young people with a psychotic disorder are almost four times more likely to have ever been admitted to hospital for mental health reasons, and twice as likely to have an emergency room visit for mental health reasons. , and more likely to have previously been diagnosed with a substance use disorder than youth diagnosed with a mood disorder.

“Our findings suggest that these factors (prior mental health-related hospital admissions and emergency room visits, as well as a prior substance use disorder diagnosis) may indicate an increased risk of psychotic disorder,” explains Dr. Nicole Kozloff, co-director of Slaight. Family center for youth in transition at CAMH. “These findings are remarkably consistent with those from other jurisdictions outside of Canada and should guide further research into earlier detection and intervention in the course of psychotic illness.”

In the study, researchers used ICES health service use information and other related data to examine past mental health service use among Ontarians aged 15 at age 29 who were subsequently diagnosed with a psychotic disorder between April 1, 2012 and March 31. , 2018. The team identified more than 10,000 people with a first diagnosis of a psychotic disorder and compared them to people diagnosed with a mood disorder.

“People at risk for psychosis are hiding in plain sight,” says Dr. Aristotle Voineskos, vice president for research at CAMH and director of the Campbell Family Mental Health Research Institute. “These data provide a very different picture of who is at risk for psychosis and also suggest the opportunity to move forward to examine whether effective treatment for prior conditions can modify psychosis risk.”

Initial findings from this research inspired the launch of the Toronto Adolescent & Youth (TAY) cohort study at CAMH. This five-year study follows 1,500 children and young people presenting for mental health services, examining their biology, education and cognition, social factors and service use patterns. The goal is to better understand who is at risk for psychosis and, importantly, how to mitigate this risk through earlier intervention.

This research underpins a key pillar of CAMH's new strategic plan, Get Upstream, which aims to position the hospital at the forefront of early identification of mental illness, prevention strategies and rapid access to high quality care.

CAMH is already a leader in research and clinical care for young people suffering from psychosis. Slaight Family Center for Youth in Transition's unique integrated approach translates the latest clinical and scientific evidence into better intervention and recovery strategies, making a real difference in young people's lives. The Slaight Center is home to an outpatient early psychosis intervention program, a high-risk clinical program, and an inpatient early psychosis unit, which treat more than 425 patients on average each month aged 14 to 29.

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About the Center for Addiction and Mental Health (CAMH)

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