Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-19T04:08:39.771Z Has data issue: false hasContentIssue false
  • English
  • Français

Illness characteristics and symptoms in an Irish early intervention for psychosis service

Published online by Cambridge University Press:  18 December 2014

J. P. Lyne ,
B. O’Donoghue ,
E. Roche ,
C. Behan ,
I. Jordan ,
L. Renwick ,
N. Turner ,
E. O’Callaghan  and
M. Clarke
J. P. Lyne*
Affiliation:
Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland
B. O’Donoghue
Affiliation:
Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland Orygen Youth Health Research Centre, University of Melbourne, Melbourne, Australia
E. Roche
Affiliation:
Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland
C. Behan
Affiliation:
Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland
I. Jordan
Affiliation:
Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland
L. Renwick
Affiliation:
Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland School of Nursing Midwifery and Social Work, University of Manchester, Manchester, UK
N. Turner
Affiliation:
Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland St. John of God Community Services Ltd, Blackrock, Co. Dublin, Ireland
E. O’Callaghan
Affiliation:
Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland St. John of God Community Services Ltd, Blackrock, Co. Dublin, Ireland
M. Clarke
Affiliation:
Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland St. John of God Community Services Ltd, Blackrock, Co. Dublin, Ireland
*
*Address for correspondence: J. P. Lyne, DETECT Services, Avila House, Block 5 Blackrock Business Park, Blackrock, Co. Dublin, Ireland. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

Study of illness characteristics and symptoms in a young population with psychosis can assist for understanding of their needs, and can inform service planning strategies. The aims of the current study were to describe illness characteristics and symptoms of a first episode psychosis (FEP) sample aged 25 years and under, and compare with a sample aged over 25 years.

Methods

Interviews were conducted for 437 individuals aged 16–65 years presenting with suspected psychosis between 2005 and 2012 in a defined catchment area (population of 390 000) using the Structured Clinical Interview for DSM IV to determine the presence of a psychosis diagnosis. Individuals with confirmed psychosis were assessed using standardised instruments to determine illness characteristics at first presentation.

Results

Among the 25 years, and under FEP sample, 23.9% had their first onset of symptoms (prodromal or psychotic) before 18 years of age. After controlling for confounders, the sample aged 25 years and under had a significantly shorter log transformed duration of untreated psychosis (p=0.002), more negative symptoms (p=0.045) and greater frequency of comorbid cannabis abuse diagnosis (p=0.027).

Conclusions

Symptom onset in a youth FEP sample frequently occurs before age 18 years. Certain illness characteristics differed across the age categories, such as greater negative symptoms and cannabis abuse in the youth sample. Overall, the findings support the provision of adequate strategies for management of negative symptom deficits and substance abuse across all ages in FEP.

Keywords

Cannabis abusecharacteristicsfirst episode psychosisnegative symptomsyouth mental health
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 32 , Issue 1: Special Issue: Youth Mental Health , March 2015 , pp. 147 - 154
Copyright
© College of Psychiatrists of Ireland 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

✠

Deceased.

References

Addington, D, Addington, J, Maticka-Tyndale, E (1993). Assessing depression in schizophrenia: the Calgary Depression Scale. The British Journal of Psychiatry. Supplements 22, 39–44.Google Scholar
Alvarez-Jimenez, M, Gleeson, JF, Henry, LP, Harrigan, SM, Harris, MG, Killackey, E, Bendall, S, Amminger, GP, Yung, AR, Herrman, H, Jackson, HJ, McGorry, PD (2012). Road to full recovery: longitudinal relationship between symptomatic remission and psychosocial recovery in first-episode psychosis over 7.5 years. Psychological Medicine 42, 595–606.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association: Arlington, VA.Google Scholar
Andreasen, NC (1984 a). The Scale for the Assessment of Negative Symptoms (SANS). University of Iowa: Iowa City, IA.Google Scholar
Andreasen, NC (1984 b). The Scale for the Assessment of Positive Symptoms (SAPS). University of Iowa: Iowa City, IA.Google Scholar
Andreasen, NC, Carpenter, WT Jr, Kane, JM, Lasser, RA, Marder, SR, Weinberger, DR (2005). Remission in schizophrenia: proposed criteria and rationale for consensus. American Journal of Psychiatry 162, 441–449.Google Scholar
Angermeyer, MC, Kuhn, L (1988). Gender differences in age at onset of schizophrenia. An overview. European Archives of Psychiatry and Neurological Sciences 237, 351–364.Google Scholar
Behan, C, Kennelly, B, O’Callaghan, E (2008). The economic cost of schizophrenia in Ireland: a cost of illness study. Irish Journal of Psychological Medicine 25, 80–87.Google Scholar
Beiser, M, Erickson, D, Fleming, JA, Iacono, WG (1993). Establishing the onset of psychotic illness. American Journal of Psychiatry 150, 1349–1354.Google Scholar
Birchwood, M, Singh, SP (2013). Mental health services for young people: matching the service to the need. The British Journal of Psychiatry. Supplements 54, s1–s2.Google Scholar
Boonstra, N, Klaassen, R, Sytema, S, Marshall, M, De Haan, L, Wunderink, L, Wiersma, D (2012). Duration of untreated psychosis and negative symptoms – a systematic review and meta-analysis of individual patient data. Schizophrenia Research 142, 12–19.Google Scholar
Bromet, EJ, Kotov, R, Fochtmann, LJ, Carlson, GA, Tanenberg-Karant, M, Ruggero, C, Chang, SW (2011). Diagnostic shifts during the decade following first admission for psychosis. American Journal of Psychiatry 168, 1186–1194.Google Scholar
Cannon-Spoor, HE, Potkin, SG, Wyatt, RJ (1982). Measurement of premorbid adjustment in chronic schizophrenia. Schizophrenia Bulletin 8, 470–484.Google Scholar
Carpenter, WT (2014). Porous diagnostic boundaries: a new emphasis for the bulletin. Schizophrenia Bulletin 40, 1–2.Google Scholar
Clarke, M, Whitty, P, Browne, S, McTigue, O, Kamali, M, Gervin, M, Kinsella, A, Waddington, JL, Larkin, C, O’Callaghan, E (2006). Untreated illness and outcome of psychosis. British Journal of Psychiatry 189, 235–240.Google Scholar
Field, A (2005). Discovering Statistics Using SPSS. SAGE Publications: London.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JB (1995). Structured Clinical Interview for DSM-IV Axis I Disorders. State Psychiatric Institute: New York.Google Scholar
Gordis, L (2009). Epidemiology. Saunders Elsevier: Philadelphia.Google Scholar
Jones, PB (2013). Adult mental health disorders and their age at onset. The British Journal of Psychiatry. Supplements 54, s5–s10.Google Scholar
Kirkbride, JB, Errazuriz, A, Croudace, TJ, Morgan, C, Jackson, D, Boydell, J, Murray, RM, Jones, PB (2012). Incidence of schizophrenia and other psychoses in England, 1950-2009: a systematic review and meta-analyses. PLoS One 7, e31660.Google Scholar
Kirkpatrick, B, Fenton, WS, Carpenter, WT Jr, Marder, SR (2006). The NIMH-MATRICS consensus statement on negative symptoms. Schizophrenia Bulletin 32, 214–219.Google Scholar
Lang, FU, Kosters, M, Lang, S, Becker, T, Jager, M (2013). Psychopathological long-term outcome of schizophrenia – a review. Acta Psychiatrica Scandinavica 127, 173–182.Google Scholar
Large, M, Sharma, S, Compton, MT, Slade, T, Nielssen, O (2011). Cannabis use and earlier onset of psychosis: a systematic meta-analysis. Archives of General Psychiatry 68, 555–561.Google Scholar
Lynch, F, Mills, C, Daly, I, Fitzpatrick, C (2006). Challenging times: prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents. Journal of Adolescence 29, 555–573.Google Scholar
Lyne, J, Renwick, L, Madigan, K, O’Donoghue, B, Bonar, M, Grant, T, Kinsella, A, Malone, K, Turner, N, O’Callaghan, E, Clarke, M (2014). Do psychosis prodrome onset negative symptoms predict first presentation negative symptoms? European Psychiatry 29, 153–159.Google Scholar
MacBeth, A, Gumley, A (2008). Premorbid adjustment, symptom development and quality of life in first episode psychosis: a systematic review and critical reappraisal. Acta Psychiatrica Scandinavica 117, 85–99.Google Scholar
McGorry, P (2013). Prevention, innovation and implementation science in mental health: the next wave of reform. The British Journal of Psychiatry. Supplements 54, s3–s4.Google Scholar
McGorry, P, Bates, T, Birchwood, M (2013). Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. The British Journal of Psychiatry. Supplements 54, s30–s35.Google Scholar
McNamara, N, McNicholas, F, Ford, T, Paul, M, Gavin, B, Coyne, I, Cullen, W, O’Connor, K, Ramperti, N, Dooley, B, Barry, S, Singh, SP (2014). Transition from child and adolescent to adult mental health services in the Republic of Ireland: an investigation of process and operational practice. Early Intervention in Psychiatry 8, 291–297.Google Scholar
Murray, CJL, Lopez, AD (1996). The Global Burden of Disease. Harvard University Press: Cambridge, MA.Google Scholar
National Institute for Health and Care Excellence (NICE) (2011). Psychosis with Coexisting Substance Misuse. Assessment and Management in Adults and Young People. National Institute for Health and Care Excellence: London.Google Scholar
Owens, DG, Miller, P, Lawrie, SM, Johnstone, EC (2005). Pathogenesis of schizophrenia: a psychopathological perspective. British Journal of Psychiatry 186, 386–393.Google Scholar
Potvin, S, Sepehry, AA, Stip, E (2006). A meta-analysis of negative symptoms in dual diagnosis schizophrenia. Psychological Medicine 36, 431–440.Google Scholar
Saha, S, Chant, D, McGrath, J (2007). A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Archives of General Psychiatry 64, 1123–1131.Google Scholar
Stefanis, NC, Dragovic, M, Power, BD, Jablensky, A, Castle, D, Morgan, VA (2013). Age at initiation of cannabis use predicts age at onset of psychosis: the 7- to 8-year trend. Schizophrenia Bulletin 39, 251–254.Google Scholar
Subramaniam, M, Zheng, H, Soh, P, Poon, LY, Vaingankar, JA, Chong, SA, Verma, S (in press). Typology of people with first-episode psychosis. Early Intervention in Psychiatry.Google Scholar
Turner, N, Browne, S, Clarke, M, Gervin, M, Larkin, C, Waddington, JL, O’Callaghan, E (2009). Employment status amongst those with psychosis at first presentation. Social Psychiatry and Psychiatric Epidemiology 44, 863–869.Google Scholar
van Mastrigt, S, Addington, J (2002). Assessment of premorbid function in first-episode schizophrenia: modifications to the Premorbid Adjustment Scale. Journal of Psychiatry and Neuroscience 27, 92–101.Google Scholar
Whitty, P, Clarke, M, McTigue, O, Browne, S, Kamali, M, Larkin, C, O’Callaghan, E (2005). Diagnostic stability four years after a first episode of psychosis. Psychiatric Services 56, 1084–1088.Google Scholar
World Health Organisation (2001). Mental Health Report 2001. Mental Health: New Understanding, New Hope. World Health Organisation: Geneva.Google Scholar