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Predicting early transition from sub-syndromal presentations to major mental disorders

Published online by Cambridge University Press:  02 January 2018

Shane P.M. Cross
Affiliation:
Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
Jan Scott
Affiliation:
Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle, UK
Ian B. Hickie
Affiliation:
Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
Corresponding
E-mail address:
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Abstract

Background

Transition from at-risk state to full syndromal mental disorders is underexplored for unipolar and bipolar disorders compared with psychosis.

Aims

Prospective, trans-diagnostic study of rates and predictors of early transition from sub-threshold to full syndromal mental disorder.

Method

One-year outcome of 243 consenting youth aged 15–25 years with a sub-syndromal presentation of a potentially severe mental disorder. Survival analysis and odds ratio (OR) for predictors of transition identified from baseline clinical and demographic ratings.

Results

About 17% (n=36) experienced transition to a major mental disorder. Independent of syndromal diagnosis, transition was significantly more likely in individuals who were NEET (not in education, employment or training), in females and in those with more negative psychological symptoms (e.g. social withdrawal).

Conclusions

NEET status and negative symptoms are modifiable predictors of illness trajectory across diagnostic categories and are not specific to transition to psychosis.

Type
Paper
Copyright
Copyright © The Royal College of Psychiatrists 2017

Footnotes

Declaration of interest

I.B.H. has been a Commissioner in Australia's National Mental Health Commission since 2012. He was a board member of headspace: National Youth Mental Health Foundation until January 2012. He has led a range of community-based and pharmaceutical industry-supported depression awareness and education and training programmes. He has led projects for health professionals and the community supported by governmental, community agency and pharmaceutical industry partners (Wyeth, Eli Lilly, Servier, Pfizer, AstraZeneca) for the identification and management of depression and anxiety. He has received honoraria for presentations of his own work at educational seminars supported by a number of non-government organisations and the pharmaceutical industry (including Servier, Pfizer, AstraZeneca and Eli Lilly). He is a member of the Medical Advisory Panel for Medibank Private and also a board member of Psychosis Australia Trust. He leads an investigator-initiated study of the effects of agomelatine on circadian parameters (supported in part by Servier) and has participated in a multicentre clinical trial of the effects of agomelatine on sleep architecture in depression and a Servier-supported study of major depression and sleep disturbance in primary care settings.

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