Age of onset of mental disorders and use of mental health services: needs, opportunities and obstacles

2011 ◽  
Vol 21 (1) ◽  
pp. 47-57 ◽  
Author(s):  
G. de Girolamo ◽  
J. Dagani ◽  
R. Purcell ◽  
A. Cocchi ◽  
P. D. McGorry
Keyword(s):  
Early Intervention ◽  
Mental Disorders ◽  
Transition To Adulthood ◽  
Psychotic Disorders ◽  
Age Of Onset ◽  
Early Stage ◽  
Early Adulthood ◽  
Special Focus ◽  
Long Term Effects ◽  
Health Services Needs

Purpose of review.In this review, we provide an update of recent studies on the age of onset (AOO) of the major mental disorders, with a special focus on the availability and use of services providing prevention and early intervention.Recent findings.The studies reviewed here confirm previous reports on the AOO of the major mental disorders. Although the behaviour disorders and specific anxiety disorders emerge during childhood, most of the high-prevalence disorders (mood, anxiety and substance use) emerge during adolescence and early adulthood, as do the psychotic disorders. Early AOO has been shown to be associated with a longer duration of untreated illness, and poorer clinical and functional outcomes.Summary.Although the onset of most mental disorders usually occurs during the first three decades of life, effective treatment is typically not initiated until a number of years later. There is increasing evidence that intervention during the early stages of disorder may help reduce the severity and/or the persistence of the initial or primary disorder, and prevent secondary disorders. However, additional research is needed on effective interventions in early-stage cases, as well as on the long-term effects of early intervention, and for an appropriate service design for those with emerging mental disorders. This will mean not only the strengthening and re-engineering of existing systems, but is also crucial the construction of new streams of care for young people in transition to adulthood.

Military Service in Midlife

2017 ◽  
Author(s):  
Meredith Kleykamp ◽  
Ryan Kelty ◽  
David R. Segal
Keyword(s):  
Transition To Adulthood ◽  
Military Service ◽  
Early Adulthood ◽  
The United States ◽  
Institutional Setting ◽  
Special Focus ◽  
Post Traumatic Growth ◽  
Post Traumatic ◽  
Psychosocial Benefits ◽  
The Military

This chapter examines the role of military experience on positive or negative development and functioning in early adulthood. It reviews the demographic composition of the military in the United States, with attention to the diversity of those who serve. It reviews how military service influences the transition to adulthood, now serving as a pathway toward, rather than an interruption of, adulthood. It summarizes the wealth of research connecting military service to midlife outcomes, with a special focus on how military experiences may generate positive growth and resilience. Although some who serve may experience trauma, military service can also provide material and psychosocial benefits, including post-traumatic growth. Notably, the benefits of military service tend to accrue most for individuals who come from more disadvantaged backgrounds, making the military a potentially important institutional setting for a successful transition to adulthood for those who need such supports the most.

scholarly journals Dynamics of ideas about the concept of epileptic psychosis

2021 ◽  
Vol 57 (4) ◽  
pp. 113-121
Author(s):  
Y. A. Yakovleva ◽  
M. Y. Kissin ◽  
Y. V. Popov ◽  
A. A. Pichikov ◽  
N. Y. Safonova ◽  
...  
Keyword(s):  
Mental Disorders ◽  
English Language ◽  
Psychotic Disorders ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
Epileptic Focus ◽  
Scientific Databases ◽  
Depth Study ◽  
Patients With Epilepsy ◽  
The 19Th Century

Introduction: psychosis in epilepsy is more common than in the general population. The frequency of psychotic mental disorders varies from 0,5% to 10%. The article presents the dynamics of the development of the concept of epileptic psychosis, depending on the evolutionary approaches to the study of the problem of mental disorders in epilepsy. Materials and methods: the analysis of Russian—and English language articles in scientific databases on keywords from 1971 to 2011 was carried out. Results: the first systematic descriptions of mental disorders occurring in epilepsy date back to the 19th century. The contribution of foreign and domestic authors to the study of the problem is described. There are six main periods of the concept formation, including the definitions of the concept of epileptic psychosis, the dynamics of clinical manifestations, the role of the influence of biological, personal and social factors in the genesis and development of psychotic disorders in epilepsy. The following risk factors for the development of psychosis are considered: the form of epilepsy; age of onset of seizures, lateralization of the epileptic focus, gender, and drug therapy. Variants of classification approaches to the problem are presented. The article discusses the differences in the systematization of «endoform» syndromes, as well as the parallels between schizophrenia and psychoses in epilepsy. The dynamics of scientific views on the interest in the formation of epileptic psychoses in various parts of the brain: the temporal lobe (amygdala, hippocampus, paralimbic zones and parahippocampal bend), as well as GABA-ergic neurons of the upper tubercles of the quadriplegic, posterior hypothalamus and serotonergic neurons of the dorsal suture and noradrenergic neurons of the blue spot are reflected. The association of psychopathological manifestations with neurophysiological, biochemical, genetic and morphofunctional correlates is noted. The authors‘ interest in psychoses associated with the use of antiepileptic drugs is emphasized. Conclusion: despite all attempts to systematize these conditions, the factors that provoke the development of psychoses in patients with epilepsy, their structure and prognosis remain poorly predictable and require further in-depth study.

Neuroendocrine markers of high risk for psychosis: salivary testosterone in adolescent boys with prodromal symptoms

2011 ◽  
Vol 41 (9) ◽  
pp. 1815-1822 ◽  
Author(s):  
S. van Rijn ◽  
A. Aleman ◽  
L. de Sonneville ◽  
M. Sprong ◽  
T. Ziermans ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Age Of Onset ◽  
Early Adulthood ◽  
Total Sample ◽  
Psychotic Symptoms ◽  
Pubertal Stage ◽  
Prodromal Symptoms ◽  
Salivary Testosterone ◽  
Male Adolescents ◽  
Neuroendocrine Factors

BackgroundThe peak in age of onset of psychotic disorders such as schizophrenia during puberty and early adulthood suggests a relationship between the expression of psychopathology and the changes in the brain and body that take place during this dynamic maturational period, including a dramatic increase in circulating oestrogens and androgens. This study examined levels of salivary testosterone and oestradiol in adolescents with prepsychotic, prodromal symptoms, as this may mediate risk for psychosis by having an impact on brain development.MethodIn 21 male adolescents with prodromal symptoms and 21 male non-clinical controls levels of testosterone and oestradiol were measured in saliva. Tanner pubertal stage and prodromal symptoms were also assessed.ResultsLevels of testosterone were significantly lower in adolescents with prodromal symptoms as compared with non-clinical controls. No group differences in oestradiol were found. In the total sample, level of testosterone was significantly correlated with age and Tanner pubertal stage.ConclusionsOur observations are in line with current hypotheses stressing the role of neuroendocrine factors during adolescence in the expression of psychotic symptoms. From a developmental perspective, susceptibility to psychotic disorders increases during adolescence. Our data suggest that testosterone might, in part, mediate this increased vulnerability. Further research is needed to assess the mediating, neural, mechanisms through which testosterone may have an impact on the development of psychotic symptoms. In the search for early risk markers for psychosis, studying neuroendocrine factors might increase our understanding of ‘at-risk’ developmental pathways.

scholarly journals Prevention, innovation and implementation science in mental health: the next wave of reform

2013 ◽  
Vol 202 (s54) ◽  
pp. s3-s4 ◽  
Author(s):  
Patrick McGorry
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Early Intervention ◽  
Mental Disorders ◽  
Human Health ◽  
Implementation Science ◽  
Early Adulthood ◽  
Economic Productivity ◽  
Corrosive Effect ◽  
The Impact

SummaryAlthough the corrosive effect of mental ill health on human health and happiness has long been recognised, it is only relatively recently that mental illness has been acknowledged as one of the major threats to economic productivity worldwide. This is because the major mental disorders most commonly have their onset during adolescence and early adulthood, and therefore have a disproportionate impact on the most productive decades of life. With the costs associated with mental ill health estimated to double over the next two decades, a greater emphasis on prevention and early intervention has become even more imperative. Although prevention largely remains aspirational for many reasons, early intervention is well within our current reach and offers the potential to significantly reduce the impact of mental ill health on our health, happiness and prosperity in the immediate future.

Psychosis High-Risk States

2018 ◽  
pp. 838-858
Author(s):  
Luís Madeira ◽  
Ilaria Bonoldi ◽  
Barnaby Nelson
Keyword(s):  
Early Intervention ◽  
Primary Prevention ◽  
High Risk ◽  
Mental Disorders ◽  
Translational Research ◽  
Clinical Features ◽  
Psychotic Disorders ◽  
Major Field ◽  
The World ◽  
Phenomenological Psychopathology

Psychosis High-Risk states are today a major field of research in psychiatry allowing early intervention (including primary prevention) of severe psychotic disorders. Psychosis High-Risk criteria select different clinical features and appear to be different center-wise and country-wise. As several of the phenomena accounting for symptoms are subjective in nature, both original and recent inputs from research in phenomenological psychopathology are great candidates for adding to the conceptual validity of High-Risk states. These subjects show a disturbed grip on reality–perplexity, derealization, and depersonalization—as well as a diminished presence in the world and involuntarily ruminating on things they previously ignored. Special sets of phenomena are presented including Truman symptoms, anomalous subjective self and world experiences, and abnormal bodily phenomena. Contemporary predictive and translational research will ultimately integrate phenomenological data with the neurocognitive and neurobiological models of mental disorders.

The Status of Early Intervention Services in Greece

2017 ◽  
Vol 41 (S1) ◽  
pp. S728-S729
Author(s):  
S.I. Bargiota ◽  
G. Garyfallos ◽  
V.P. Bozikas
Keyword(s):  
Early Intervention ◽  
Psychotic Disorders ◽  
Positive Impact ◽  
Early Adulthood ◽  
Published Data ◽  
Early Intervention Services ◽  
The World ◽  
The Status ◽  
Intervention Services ◽  
Competing Interest

IntroductionSchizophrenia and other psychotic disorders usually emerge during adolescence and early adulthood deteriorating the lives of young people. As a result, a lot of early intervention services have been developed worldwide.ObjectiveThis study aims to investigate the status of early intervention services in Greece related to similar programs around the world.MethodsThe literature was accessed in order to investigate the status of clinical early intervention services throughout the world. In terms of Greece, a naturalistic research was added to the literature one, since there are not enough published data available.ResultsHundreds of early intervention programs exist in Australia, Europe, North America and Asia, designed to provide early and sustained care with less prescription not only soon after psychosis has been diagnosed but in a prodromal state as well, like the outreach and support in South London (OASIS) team. In Greece, four early intervention services have been established since 2007, without funding, and they still operate in a volunteer basis. Furthermore, the field about ultra-high risk subjects in Greece remains neglected.ConclusionsThe specialized services play an important role in the prevention and proper clinical management of the illness and its outcome with a positive impact on the economy. Greece needs to recognize the significance of this issue in order to enhance public health and welfare.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Early-adult outcome of child and adolescent mental disorders as evidenced by a national-based case register survey

2016 ◽  
Vol 38 ◽  
pp. 45-50 ◽  
Author(s):  
A.C. Castagnini ◽  
L. Foldager ◽  
E. Caffo ◽  
P.H. Thomsen
Keyword(s):  
Mental Disorders ◽  
Psychotic Disorders ◽  
Psychiatric Morbidity ◽  
Early Adulthood ◽  
Child And Adolescent ◽  
Conduct Disorders ◽  
Childhood And Adolescence ◽  
Obsessive Compulsive ◽  
Case Register ◽  
Heterotypic Continuity

AbstractBackgroundMental disorders show varying degrees of continuity from childhood to adulthood. This study addresses the relationship of child and adolescent mental disorders to early adult psychiatric morbidity.MethodsFrom a population at risk of 830,819 children and adolescents aged 6-16 years, we selected all those (n = 6043) who were enrolled for the first time in the Danish Psychiatric Register with an ICD-10 F00-99 diagnosis in 1995-1997, and identified any mental disorder for which they received treatment up to 2009.ResultsNeurodevelopmental and conduct disorders were the principal diagnostic groups at 6-16 years and exhibited a characteristic male preponderance; while affective, eating, neurotic, stress-related and adjustment disorders were more common in girls. Over a mean follow-up period of 10.1 years, 1666 (27.6%) cases, mean age 23.4 years, were referred for treatment to mental health services, and they had a markedly higher risk than the general population (RR 5.1; 95% CI 4.9-5.4). Affective, eating, neurodevelopmental, obsessive-compulsive and psychotic disorders had the strongest continuity. Heterotypic transitions were observed for affective, eating, neurodevelopmental, personality and substance use disorders.ConclusionsThese findings suggest that individuals with psychiatric antecedents in childhood and adolescence had a high risk of being referred for treatment in early adulthood, and many mental disorders for which they required treatment revealed both homotypic and heterotypic continuity.

Intervening early in bipolar disorder in young people: a review of the clinical staging model

2015 ◽  
Vol 32 (1) ◽  
pp. 31-43
Author(s):  
P. Power
Keyword(s):  
Bipolar Disorder ◽  
Early Intervention ◽  
Young People ◽  
Psychotic Disorders ◽  
Early Adulthood ◽  
General Medicine ◽  
Developmental Trajectory ◽  
Clinical Staging ◽  
Co Morbidity ◽  
Staging Model

Bipolar disorder (BPD) essentially has its onset during adolescence and early adulthood. It has the capacity to be highly disruptive, dislocating individuals from their normal developmental trajectory and potentially causing significant long-term co-morbidity and chronicity. At a societal level the burden created is greater than schizophrenia. This is not helped by the very substantial delays in its diagnosis and appropriate treatment. Thus, there is a clear rationale for intervening earlier and at a younger age. However, the field of early intervention in BPD is in its infancy. One approach that conceptually provides a basis for early intervention is the Clinical Staging Model (used widely in general medicine). This article outlines how this model helps in an understanding of the emerging stages of BPD. It also summarises the interventions that might be appropriately introduced if a person progresses from an early to a late stage of the illness. Early intervention has a well-established record in psychotic disorders. If it can be realised for BPDs, then it may hold out hope of better outcomes for the next generation of young people at risk.

scholarly journals Identification of high risk and early stage eating disorders: first validation of a digital screening tool

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Emma Bryant ◽  
Jane Miskovic-Wheatley ◽  
Stephen W. Touyz ◽  
Ross D. Crosby ◽  
Eyza Koreshe ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Early Intervention ◽  
High Risk ◽  
Mental Disorders ◽  
Screening Tool ◽  
Early Stage ◽  
Morbidity And Mortality ◽  
Statistical Validity ◽  
Eating Disorders Examination

Abstract Background Eating disorders are amongst the deadliest of all mental disorders, however detection and early intervention rates remain extremely low. Current standardised screening questionnaires can be arduous or confronting and are ill-validated for online use, despite a universal shift to digital healthcare. The present study describes the development and pilot validation of a novel digital screening tool (the InsideOut Institute-Screener) for high risk and early stage eating disorders to drive early intervention and reduced morbidity. Methods We utilised a mixed cross-sectional and repeated measures longitudinal survey research design to assess symptom severity and recognised parameters of statistical validity. Participants were recruited through social media and traditional advertising, and through MTurk. An Eating Disorders Examination Questionnaire (EDE-Q) global score of 2.3 and assessment of eating disorder behaviours was used to determine probable ED. 1346 participants aged 14–74 (mean [SE] age 26.60 [11.14] years; 73.8% female, 22.6% male) completed the survey battery. 19% were randomised to two-week follow-up for reliability analysis. Results Strong positive correlations between the IOI-S and both the EDE-Q global (rs = .88) and SCOFF (rs = .75) total score were found, providing support for the concurrent validity of the scale. Inter-item correlations were moderate to strong (rs = .46–.73). Correlations between the IOI-S and two measures of social desirability diverged, providing support for the discriminant validity of the scale. The IOI-S demonstrated high internal consistency (α = .908, ω = .910) and excellent two-week test–retest reliability (.968, 95% CI 0.959–0.975; p ≤ 0.1). The IOI-S accurately distinguished probable eating disorders (sensitivity = 82.8%, specificity = 89.7% [AUC = .944], LR+  = 8.04, LR− = 0.19) and two stepped levels of risk. Conclusions and relevance The present study provides excellent initial support for the psychometric validity of the InsideOut Institute digital screening tool, which has the potential to streamline early intervention in the hopes of reducing current high morbidity and mortality. Further validation should be undertaken in known clinical populations. Plain English Summary Eating disorders are amongst the deadliest of all mental disorders, however detection and early intervention rates remain extremely low. The present study describes the initial psychometric validation of a novel digital screening tool (the InsideOut Institute Screener) for high risk and early stage eating disorders, for self-referral and/or use in primary care. 1346 participants aged 14–74 of all genders completed a survey battery designed to assess common parameters of statistical validity. Strong support was found for the screener’s ability to accurately measure eating disorder risk and symptomatology. The screener was highly positively correlated with a well known and extensively validated long form self-report questionnaire for eating disorder symptomatology. This study is a pilot validation and the genesis of a project that aims ultimately to drive early intervention leading to reduced morbidity and mortality rates in this illness group.

Psychosocial Risks and Management for Children and Adolescents With 22q11.2 Deletion Syndrome

2019 ◽  
Vol 4 (4) ◽  
pp. 633-640 ◽  
Author(s):  
Canice E. Crerand ◽  
Ari N. Rabkin
Keyword(s):  
Cognitive Abilities ◽  
Psychotic Disorders ◽  
Developmental Stages ◽  
Early Adulthood ◽  
22Q11.2 Deletion Syndrome ◽  
Deletion Syndrome ◽  
22Q11.2 Deletion ◽  
Psychosocial Risks ◽  
Empirically Supported ◽  
Specific Education

Purpose This article reviews the psychosocial risks associated with 22q11.2 deletion syndrome, a relatively common genetic condition associated with a range of physical and psychiatric problems. Risks associated with developmental stages from infancy through adolescence and early adulthood are described, including developmental, learning, and intellectual disabilities as well as psychiatric disorders including anxiety, mood, and psychotic disorders. Other risks related to coping with health problems and related treatments are also detailed for both affected individuals and their families. Conclusion The article ends with strategies for addressing psychosocial risks including provision of condition-specific education, enhancement of social support, routine assessment of cognitive abilities, regular mental health screening, and referrals for empirically supported psychiatric and psychological treatments.

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