Schizophrenia may be identified years before symptoms appear

According to new research, the risk of schizophrenia and bipolar disorder may be identifiable years before the illnesses manifest.

The Health Research Board-funded study, which was led by University College Dublin, found that 50% of those who developed these mental health issues had used the services of Specialised Child and Adolescent Mental Health Services (CAMHS).

Professor Ian Kelleher, from the UCD School of Medicine, led the international study that was conducted in collaboration with the Finnish Institute for Health and Welfare, and the results were published in the journal World Psychiatry. According to Professor Kelleher, the findings point to the possibility of earlier intervention and even prevention (THL).

"Schizophrenia and bipolar illness generally manifest in early adulthood and can be extremely harmful to both the affected people and their families, the doctor stated.

"Our data demonstrate that half of those who experience these disorders sought help from CAMHS at some point during their childhood, usually years before experiencing schizophrenia or bipolar disorder.

These findings demonstrate the enormous opportunities to provide far earlier intervention, even while still in childhood, by developing specialist early intervention services within existing child and adolescent mental health services, which we know is essential to improving outcomes for people with serious mental illness."

About 65 million people worldwide suffer from major mental diseases like schizophrenia and bipolar disorder. Both illnesses are frequently linked to significant degrees of disability, and individual and social costs, and are typically diagnosed in adulthood. However, it is well established that early intervention improves outcomes for those who suffer from these conditions.

The authors of the new study followed every person born in 1987 throughout childhood and adolescence to determine whether they ever attended CAMHS between the ages of birth and 17. They did this using Finland's top-ranked healthcare records.

The researchers were then able to track all of these people up to the age of 28 and determine who went on to receive a diagnosis of schizophrenia or bipolar disorder by using distinctive patient identifiers.

They discovered that the likelihood of psychosis or bipolar illness by the age of 28 for people who had not seen CAMHS was 1.8%. However, the risk was 15% for those who had attended adolescent outpatient CAMHS and 37% for people who had been admitted to an inpatient adolescent CAMHS hospital.

Professor Mika Gissler, THL, stated that "this research demonstrates the power of electronic healthcare records to answer critical issues regarding human health and disease."

"It shows how healthcare register data can be used to better understand pathways to serious mental illness, from childhood into adulthood, and to identify crucial opportunities for early intervention," the study's authors write.

Professor Ian Kelleher emphasised the significance of early intervention and said, "Ideally, we would like to be able to intervene even before the onset of illness, to prevent it altogether. We know that it's crucial to intervene as early as possible to prevent some of the worst effects of these illnesses. These findings show the potential for intervening much earlier than we do now, even in infancy and adolescence, to stop the emergence of these severe mental diseases.