Psychosis is an umbrella term for a wide array of mental disorders, including schizophrenia, brief psychotic disorder, schizoaffective disorder, and delusional disorder. Psychotic disorders are often fluid, meaning they come with symptoms that cross over into other categories, like bipolar disorder and depression, which makes them difficult to identify and treat. But a new risk calculator might help psychiatrists predict a patient’s risk of developing certain disorders as accurately as cancer or heart disease, according to a new study.
The study, conducted by researchers at Beth Israel Deaconess Medical Center (BIDMC) and eight other sites, examined how well the risk calculator could predict a person’s future psychosis diagnosis, based on early warning symptoms.
“Until now, clinicians could give patients only a rough estimate of how their condition might progress — that some 15 to 25 percent of people who have experienced early warning symptoms will go on to develop a more serious disorder,” said Larry Seidman, a psychologist at BIDMC and Professor of Psychology at Harvard Medical School, in a press release. “With this new risk calculator, clinicians can now give patients an individualized assessment of risk. More precise information allows people to have a more realistic sense of what’s going on, which can reduce anxiety.”
In the study, the researchers analyzed 596 participants aged 12 to 35 years old who had been diagnosed with Attenuated Psychosis Syndrome. The condition involves hallucinations and unusual thoughts, but the patient is typically still self-aware enough to realize their perceptions aren’t realistic. To measure the risk of these patients developing schizophrenia — experiencing hallucinations and paranoia and not realizing they’re not based in reality — over time, the researchers developed the risk calculator which examined several factors. The factors included stressful life events, trauma, family history of schizophrenia, age of onset of symptoms, levels of unusual thought content and suspiciousness, social functioning, verbal learning skills, and mental processing.
The researchers tracked the participants every six months, taking all of the factors into account, and found that 16 percent of Attenuated Psychosis Syndrome patients ended up with psychosis within two years. It turned out that several factors measured acted as predictors to psychosis later on, including lower social functioning, verbal learning, and processing speed, as well as high levels of unusual thought content and suspiciousness. In additions, if patients were younger when their symptoms appeared, they seemed to be at a higher risk of psychosis later on. Interestingly, however, stressful life events, trauma, and even family history of schizophrenia had a lower impact.
Psychosis can include a variety of mental disorders, but it’s not to be confused with psychopathy or a lack of moral character. Like any other mental illness, psychosis isn’t anyone’s fault and it can be treated with medication or cognitive behavioral therapy. Diagnosing it earlier and more accurately, when the warning signs begin to appear, could help patients get the individualized help they need and possibly even prevent adverse outcomes.
“With this tool, doctors can give people who have experienced early warning symptoms of schizophrenia a much more individualized assessment of risk,” said Tyrone Cannon, professor of psychology and psychiatry at Yale and lead author of the study, in a Yale press release.
Source: Cannon T, Yu C, Addington J, Bearden C, Cadenhead K, Cornblatt B. An Individualized Risk Calculator for Research in Prodromal Psychosis. The American Journal of Psychiatry, 2016.