Treatment History of Youth At-Risk for Serious Mental Illness

Farris, Megan S.; MacQueen, Glenda; Goldstein, Benjamin I.; Wang, JianLi; Kennedy, Sidney H.; Bray, Signe; Lebel, Catherine; Addington, Jean

doi:10.1177/0706743718792195

Cited by 10 publications

(9 citation statements)

References 16 publications

(29 reference statements)

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“…Similar to our previous publication, 3 there were differences between the at-risk clinical stage groups, and by having 2 years of follow-up assessments, we observed that these same treatment patterns persisted over time. The stage 1a and 1b participants reported the highest proportions of medication use, whereas stage 0 participants, although much lower, still reported medication use across the follow-up timepoints.…”

Section: Discussionsupporting

confidence: 90%

“…We previously reported the lifetime history of and current medication treatment for individuals in various stages of risk for an SMI in the Canadian Psychiatric Risk and Outcome Study (PROCAN). 3 We found that not only did treatment history vary by at-risk groups, but that many young people with no formal diagnoses were taking medications, and that some of those young individuals had been taking medications for at least several years. 3 Our aim for this report was to determine whether the same medication treatment patterns persisted through 2 years of the PROCAN follow-up.…”

Section: Introductionmentioning

confidence: 73%

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Longitudinal Trends in Medication Treatment for Youth At-Risk for Serious Mental Illness

et al. 2021

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 73%

Longitudinal Trends in Medication Treatment for Youth At-Risk for Serious Mental Illness

et al. 2021

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“…Possible treatment effects were not accounted for in the present analyses. Approximately one‐third of individuals in the Stage 1a (32.7%) and 1b (34.3%) groups had been prescribed with either antidepressants or stimulants . About a half of the 1b (49.1%) and a quarter of 1a participants (26.9%) received psychosocial therapy (for a detailed report see tables 2 and 3 in Farris et al .…”

Section: Discussionmentioning

confidence: 99%

Aberrant limbic brain structures in young individuals at risk for mental illness

Nogovitsyn

Souza

Muller

et al. 2020

Psychiatry Clin Neurosci

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Aim Alterations in limbic structures may be present before the onset of serious mental illness, but whether subfield‐specific limbic brain changes parallel stages in clinical risk is unknown. To address this gap, we compared the hippocampus, amygdala, and thalamus subfield‐specific volumes in adolescents at various stages of risk for mental illness. Methods MRI scans were obtained from 182 participants (aged 12–25 years) from the Canadian Psychiatric Risk and Outcome study. The sample comprised of four groups: asymptomatic youth at risk due to family history of mental illness (Stage 0, n = 32); youth with early symptoms of distress (Stage 1a, n = 41); youth with subthreshold psychotic symptoms (Stage 1b, n = 72); and healthy comparison participants with no family history of serious mental illness (n = 37). Analyses included between‐group comparisons of brain measurements and correlational analyses that aimed to identify significant associations between neuroimaging and clinical measurements. A machine‐learning technique examined the discriminative properties of the clinical staging model. Results Subfield‐specific limbic volume deficits were detected at every stage of risk for mental illness. A machine‐learning classifier identified volume deficits within the body of the hippocampus, left amygdala nuclei, and medial‐lateral nuclei of the thalamus that were most informative in differentiating between risk stages. Conclusion Aberrant subfield‐specific changes within the limbic system may serve as biological evidence to support transdiagnostic clinical staging in mental illness. Differential patterns of volume deficits characterize those at risk for mental illness and may be indicative of a risk‐stage progression.

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“…[6][7][8][9] Housing and employment status, level of education, and socioeconomic status have all been associated with increased risk of mental health disorders. [10][11][12][13][14] Increasing evidence suggests that when mental health problems are not effectively treated within the context of a person's needs, they can impair self-care and adherence to medical and mental health treatments, and improperly treated mental health problems are associated with increased morbidity and mortality, increased health care costs, and decreased productivity. [15][16][17][18][19] As Patel and colleagues note, the rationale for coordinated health services for people with mental illness includes improving access to mental health care, providing patient-centred care, avoiding fragmentation of health services, reducing stigma, optimizing both mental and physical health outcomes, and strengthening the overall health system.…”

Section: Points De Repère Du Rédacteurmentioning

confidence: 99%

Social determinants of health and depression in adults presenting to the emergency department

et al. 2021

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Objective To estimate the extent to which social determinants of health (SDH) predict levels of depression in adults presenting to the emergency department (ED) with an acute mental health crisis.Design Secondary data analysis.Setting St Paul's Hospital, an urban tertiary care hospital in Vancouver, BC.Participants Patients 19 years and older presenting to the ED with an acute mental health crisis. Main outcome measuresResponses to demographic questionnaires focused on SDH and to measures of self-perceived health and depression. Relationships between depression and SDH were described using t tests and χ 2 tests. The extent to which SDH variables predicted depression scores, as measured by the Patient Health Questionnaire-9 (PHQ-9), was determined using linear regression. ResultsThe primary study had 202 participants. Data for the 156 (77%) participants who completed the PHQ-9 were assessed in this secondary analysis. In this sample, 60% of participants identified as men, 37% as women, and 4% as other. The mean (SD) age was 39.1 (13.8) years, with most participants identifying as white (65%) or Indigenous (18%). Thirty-seven percent had a high school diploma or less education, and 72% reported being unemployed. Identifying as a woman, lack of access to clean drinking water, poor food security, feeling unsafe, little structured use of time, lack of a sense of community, and dissatisfaction with housing significantly predicted higher depression scores. Overall, 59% of respondents met the criteria for moderately severe or severe depression (PHQ-9 score ≥ 15), with 37% of those reporting thoughts of suicide nearly every day for the past 2 weeks. ConclusionThis study demonstrates the importance of screening for both depression and SDH in the ED. Because the ED often does not have the capacity to address appropriate levels of follow-up for this population, this study has important implications for primary care. Developing a clear pathway of followup support for people with depression and SDH risk factors will be critical to optimize patient outcomes, promote patient safety, enhance patient satisfaction, and optimize the use of resources between the ED and primary care. This article has been peer reviewed. Cet article a fait l'objet d'une révision par des pairs.

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Treatment History of Youth At-Risk for Serious Mental Illness

Abstract: We found that treatment history for participants in the PROCAN study differed among the at-risk groups. Future initiatives focused on determining the effects of treatment history on SMI are warranted.

Cited by 10 publications

References 16 publications

Longitudinal Trends in Medication Treatment for Youth At-Risk for Serious Mental Illness

Longitudinal Trends in Medication Treatment for Youth At-Risk for Serious Mental Illness

Aberrant limbic brain structures in young individuals at risk for mental illness

Social determinants of health and depression in adults presenting to the emergency department

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