Treatment History of Youth At-Risk for Serious Mental Illness [2018]

The aim was to describe treatment history including medications, psychosocial therapy and hospital visits of participants in the Canadian Psychiatric Risk and Outcomes Study (PROCAN).

PROCAN is a 2-site study of 243 youth/young adults aged 12 to 25 y, categorized into 4 groups: healthy controls (n = 42), stage 0 (non-help seeking, asymptomatic with risk mainly family history of serious mental illness (SMI); n = 41), stage 1a (distress disorders; n = 52) and stage 1b (attenuated syndromes; n = 108). Participants were interviewed regarding lifetime and current treatments, including medications, psychosocial therapies and hospital visits.

The number receiving baseline medications differed significantly across groups (P < 0.001): 0% healthy controls, 14.6% stage 0, 32.7% stage 1a and 34.3% stage 1b. Further, 26.9% and 49.1% of stage 1a and stage 1b participants received psychosocial therapy at baseline, indicative of statistically significant differences among the groups (P < 0.001). Similar results were observed for lifetime treatment history; stage 1b participants had the highest frequency of lifetime treatment. Medications started in adulthood (>18 y of age) were the most common for initiation of treatment compared to childhood (0 to 12 y) and adolescence (13 to 17 y) for stage 1a and 1b participants. Lifetime mental health hospital visits differed significantly across groups (P < 0.001) and were most common in stage 1b participants (29.6%) followed by stage 1a (13.5%), stage 0 (4.9%) and healthy controls (2.4%).

We found that treatment history for participants in the PROCAN study differed among the at-risk groups. Future initiatives focused on determining the effects of treatment history on SMI are warranted.

Megan S. Farris, MSc, Glenda MacQueen, MD PhD, Benjamin I. Goldstein, MD, JianLi Wang, PhD, Sidney H. Kennedy, MD, Signe Bray, PhD, Catherine Lebel, PhD, Jean Addington, PhD

The Canadian Journal of Psychiatry, August 2, 2018