Schizophrenia and Bipolar Disorder May Be Detectable Years Before Illnesses Begin

Summary: Researchers report bipolar depression and schizophrenia may be detectable several years before symptoms appear. A new study reports 50% of patients diagnosed with schizophrenia or bipolar disorder attended specialist child and adolescent mental health services during childhood.

Source: TCD

The risk of schizophrenia and bipolar disorder may be detectable years before the illnesses begin, according to new research.

A University College Dublin led study funded by the Health Research Board has found that 50% of people who developed these mental health disorders had attended specialist child and adolescent mental health services (CAMHS) in childhood.

Published in the journal World Psychiatry, the findings suggest the possibility of earlier intervention and even prevention according to Professor Ian Kelleher, from the UCD School of Medicine, who led the international study which was carried out in conjunction with the Finnish Institute for Health and Welfare (THL).

“Schizophrenia and bipolar disorder typically emerge in early adulthood and can have a devastating impact on the individuals affected, as well as on their families,” he said.

“Our findings show that half of individuals who develop these illnesses had come to CAMHS at some stage in childhood, typically many years before they developed schizophrenia or bipolar disorder.

“We know that early intervention is key to improving outcomes for people with serious mental illness. 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”.

Schizophrenia and bipolar disorder are serious mental illnesses affecting about 65 million people worldwide.   Both disorders are usually diagnosed in adulthood and are often associated with high levels of disability, personal and societal cost. Early intervention, however, is known to lead to better outcomes for people affected by these illnesses.

The researchers behind the new study used Finland’s world-leading healthcare registers to trace all individuals born in 1987 throughout childhood and adolescence to see if, between birth and age 17 years, they ever attended CAMHS.

Using unique patient identifiers, the researchers were then able to follow all these individuals up to age 28 years and see who went on to be diagnosed with schizophrenia or bipolar disorder.

This shows a depressed looking man
Schizophrenia and bipolar disorder are serious mental illnesses affecting about 65 million people worldwide. Image is in the public domain

They found that the risk of psychosis or bipolar disorder by age 28-years-old was 1.8% for individuals who had not attended CAMHS. For individuals who had attended outpatient CAMHS in adolescence, however, the risk was 15% and for individuals who had been admitted to an inpatient adolescent CAMHS hospital, the risk was 37%.

“This research shows the power of electronic healthcare registers to answer important questions about human health and disease,” said Professor Mika Gissler, THL.

“It demonstrates how healthcare register data can be used to better understand pathways to serious mental illness, from childhood into adulthood, and to identify critical opportunities for early intervention.”

Stressing the importance of early intervention, Professor Ian Kelleher said: “We know it’s crucial to intervene as early as possible to prevent some of the worst effects of these illnesses. But ideally, we would like to be able to intervene even before the onset of illness, to prevent it altogether.

These findings highlight the possibility of intervening far earlier than we do at present, even in childhood and adolescence, to prevent these serious mental illnesses from emerging”.

About this mental health research news

Author: Dominic Martella
Source: TCD
Contact: Dominic Martella – TCD
Image: The image is in the public domain

Original Research: The findings will appear in World Psychiatry

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  1. I thought this article – being in a neuroscience publication – was going to tell us about biological markers that usefully predict these poorly defined and controversial mental illnesses.

    Instead, this genuinely pointless article correlates measures of mental problems early in life with measures of mental problems later in life – and offers this insight with an air of genuine discovery.

    I’m used to seeing the great psychological discoveries of the 20th century being steadily buried in a mountain of wildly premature brain talk. But this article doesn’t even give us that!

  2. Hahaha…I think the study just linked by tracing the present to the past, simple. In other words, the study finding simply suggested that, some people who suffered schizophrenia or bipolar disorders in the present had in the past developed it or a trace of the disorders were detected but were not adequately treated or handled & so led to the present full disorders of today all within that age groups & so recommended that, early detection or trace of schizophrenia or bipolar disorders are OK in the past & to avoid it reoccurrences in the future, it should be equally & adequately treated & managed.
    So, it the study didn’t suggest that, schizophrenia or bipolar disorders in children of the past will be a sure possibility for it to develop in full in future, of course not!
    I hope my explanations & understandings would help to make other people understand the findings & recommendations of the study.

  3. It’s 2022 and there are still some academic psychiatrists who think that early intervention will work. “Early intervention” appears quite a bit here, probably because it’s still a buzz phrase that funding bodies like even though it is deliberately vague. They are vague because these early intervention studies have already been conducted, the results tend to be spectacularly disappointing, and probably moat disturbing is that the “early intervention” is 2nd generation/atypical antipsychotics… kids. That’s the unsavoury detail always missing from this fluff research and PR: antipsychotics for kids.

    A big issue here is how do you predict who will go on to develop schizophrenia and who bipolar spectrum disorder. Under FDA and NICE both illnesses are in firing line for different antipsychotics. I imagine this would lead to more salami slicing in psychiatry: e.g., in UK it’s a no no to use olanzapine in bipolar outside of acute crisis but is a mainstay for schizophrenia and, likewise, quetiapine is rarely prescribed for schizophrenia but has become a real low point in treatment for bipolar.

    Thus isn’t new data. We already knew this. There will be no new treatment cause “treatment” in both groups is almost exclusively all the nastiest drugs a medic could prescribe so they’re disingenuous. They mean antipsychotics. And that work has already been done.

    I’m sure this pub will look good on the authors’s CVs though and that’s what its legacy is.

  4. Haha! Am I missing something? I got one for you: a group of researchers studied a group of people and found that present problems are correlated with past problems. It’s ground breaking research. Now, we just need to tell all of the upset people, that if they feel bad now, there’s evidence that predicts they are likely to feel bad later!! Here’s an even more intriguing theory. Since correlation apparently holds so much weight, maybe going to county mental health is a cause of later distress (I’m choosing “distress” purposefully not because I’m uneducated, but because all these diagnoses have been shown to be a bunch of labels that don’t add up to much and if you tell the truth about that, you’re seen as un-schooled). Hey, anyone think that poverty, poor health, relational trauma, and maybe modern society might have something to do with so much unrest!

    1. Spot on. Your reply said much, so clearly and concisely with a just a few words. This is one of the worse “research” articles I have ever read. Yes, I do think poverty, poor health, racism,abuse and trauma at any time of life, as well as childhood neglect and abuse and any number of the different insane aspects of all societies throught the world that have always existed can be and often are a factor/trigger in the mental illnesses that some unfortunate people bravely endure.

  5. So, query: how does one “prevent” a mental illness? Assuming you’re basing your diagnosis on biological/genetic factors – not childhood trauma or events, which have already been proven to have lasting impacts into adulthood – what is the proposed solution here? Also if you’re still tracking based on previous medical interventions, that’s not really preventing anything it’s just noticing patterns that continue into adulthood. What do the kids have in common otherwise that suggests their suffering is preventable? Instead of victim blaming children or rushing to diagnosis, where is the rest of the data exposing what the children are coping with / external factors / social events that might be playing into this as well? It seems dubious to suggest “Hey, if you had a hard time as a kid you could have issues as an adult.” I also worry drug companies will only see this as an opportunity to overmedicate the population at even younger ages.

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