A new study led by Associate Professor Kristin Cleverley from the Lawrence Bloomberg Faculty of Nursing has found evidence that adolescents seeking psychiatric services often experience psychosis spectrum symptoms (PSS).
From a profile of the initial 417 adolescents aged 11 to 24 participating in the study, it was shown that 50% reached the threshold for psychosis spectrum symptoms, a number that Cleverley says was higher than expected, indicating a large number of children experiencing these symptoms when accessing psychiatric services.
Cleverley, who also holds CAMH Chair in Mental Health Nursing Research, stated that this study’s novelty lies in evaluating early indicators that could predict if someone is at higher risk of developing a psychosis spectrum disorder and examining if such a point exists, at which earlier intervention for this adolescent could be more effective.
„Traditionally, early psychosis intervention begins when severe psychotic symptoms occur, usually in late adolescence. The current approach to identifying children at risk of developing a psychotic disorder is only about 5% effective, but with this study, we can start to evaluate specific patterns or functional changes that may indicate if earlier intervention could be beneficial.“
– Kristin Cleverley, Associate Professor at the Lawrence Bloomberg Faculty of Nursing
Possibly extremely debilitating, psychosis spectrum disorder is associated with cognitive impairments, long-term disabilities, and a higher mortality rate from suicide than other mental illnesses. Even without a diagnosis of psychosis, psychosis spectrum symptoms can severely affect adolescents.
This study is one of the three projects to be conducted as part of the Toronto Adolescent and Youth (TAY) Cohort Study, which aims to follow 1500 adolescents over a period of five years. The cohort study’s goal is to better understand the population of young people seeking mental health treatment, how their mental health symptoms and functioning change over time, and whether early predictors for a psychosis spectrum disorder can be determined.
Conceived in collaboration with patients and caregivers, this study also involved comprehensive clinician involvement. A novel aspect of the TAY cohort study is that adolescents have access to a patient-oriented dashboard of their research findings, which is also integrated into their medical records.
„We aimed to ensure that the study is embedded within the clinical program so that research assessments can be immediately used in clinical practice, including supporting decisions about interventions or services,“ said Cleverley.
This longitudinal study will include follow-ups every six months, providing researchers with information on whether the symptoms in these adolescents become chronic or episodic, and if these changes are related to developmental milestones, environmental stressors, or changes in mental health care.
„Our goal with this research is to better characterize this population so that we can identify new strategies to complement existing strategies for early identification of adolescents at risk of psychosis,“ said Cleverley. „It also provides an important opportunity for graduate students and researchers to develop sub-studies for this sample, enabling further research to improve mental health outcomes for young people.“
Cleverley, K., et al. (2023). The Toronto Adolescent and Youth Cohort Study: Studiendesign und frühe Daten im Zusammenhang mit Psychose-Spektrum-Symptomen, Funktionsfähigkeit und Suizidalität. Biologische Psychiatrie. Kognitive Neurowissenschaften und Neuroimaging. doi.org/10.1016/j.bpsc.2023.10.011.