Mental disorders diagnosed in childhood and at-risk mental state in a help-seeking population

Early Interv Psychiatry. 2013 May;7(2):187-92. doi: 10.1111/j.1751-7893.2012.00376.x. Epub 2012 Jul 4.

Abstract

Aim: Disorders usually first diagnosed in infancy, childhood or adolescence (DUFD-ICA) may have preceded the onset of psychosis by several years and share some co-morbidity with psychotic disorders, but only a few studies have investigated this aspect. We looked for past or current DUFD-ICA in a sample of first adult psychiatric service users assessed for the presence of an at-risk mental state with the Structured Interview for Psychosis-risk Syndromes (SIPS).

Methods: We interviewed with the SIPS 159 first-time help seekers (age range 13-30 years) at adult psychiatric services who volunteered to participate in the study. For psychiatric diagnoses, we used the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition-Text Revision. We also assessed retrospectively the presence of DUFD-ICA and administered the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning. The sample has been subdivided diagnostically into first-episode psychosis, multiple episode psychosis, ultra-high risk (UHR) and other diagnoses.

Results: The risk for having one of first-episode psychosis, multiple episode psychosis or UHR was over 3.45 higher in the DUFD-ICA-positive history group than in the non-DUFD-ICA. Grouping the UHR with the not full-blown psychosis cases resulted in a further increase of the risk to 4.71. DUFD-ICA-positive participants scored higher than non-DUFD-ICA on the Positive, Negative and Disorganization scales of the SIPS and on several core-psychotic BPRS items.

Conclusions: A positive history of DUFD-ICA increases the risk of a diagnosis of prodromal or current psychosis at help seeking. Impaired neurodevelopment may be shared among the psychoses and DUFD-ICA.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Female
  • Humans
  • Male
  • Mental Disorders / complications
  • Mental Disorders / diagnosis*
  • Mental Disorders / psychology*
  • Patient Acceptance of Health Care*
  • Prodromal Symptoms*
  • Psychotic Disorders / complications
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / psychology*
  • Retrospective Studies
  • Risk Factors