Research shows that there are potential targets for the prevention and early identification of psychotic disorders

A new study from the Center for Addiction and Mental Health (CAMH), entitled “Mental health care use before the initial diagnosis of a psychotic disorder” and published in JAMA Psychiatry, found that nearly 75% of young Ontarians with a psychotic disorder had at least one mental health visit within the three years prior to their initial diagnosis of the disorder.

The retrospective cohort study – one of the largest of its kind – suggests that young people with a psychotic disorder are almost four times as likely to have had a previous mental health-related hospital admission, and twice as likely to have had an emergency department visit due to with mental health care. , and are more likely to have a previous diagnosis of a substance use disorder than youth diagnosed with a mood disorder.

“Our findings suggest that these factors – previous mental health hospitalizations and emergency room visits, and previous diagnosis of a substance use disorder – may indicate an increased risk for a psychotic disorder,” says Dr. Nicole Kozloff , co-director of the Slaight. Family Center for Youth in Transition at CAMH. “These results are remarkably consistent with other jurisdictions outside Canada, and should guide further research into earlier detection and intervention of psychotic illness.”

As part of the study, researchers used information from ICES on health care service use and other linked data to examine prior mental health care use among Ontario residents aged 15 to 29, who later reported between April 1, 2012 and March 31, the diagnosis of psychotic disorder was made. , 2018. The team identified more than 10,000 individuals with a first diagnosis of a psychotic disorder and matched them with individuals diagnosed with a mood disorder.

“Those at risk for psychosis are ‘hiding in plain sight,’” says Dr. Aristotle Voineskos, vice president of 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 further investigate whether effective treatment of previous conditions can alter the risk of psychosis.”

The initial findings from this research provided the inspiration for the launch of the Toronto Adolescent & Youth (TAY) cohort study at CAMH. This five-year study follows 1,500 children and young people who present for mental health services, examining their biology, education and cognition, social factors and patterns of service use. The aim is to increase understanding of who is at risk for psychosis and, importantly, how that risk can be reduced through earlier interventions.